Manager/ Sr Manager – Provider Network

5 - 9 Years
Bengaluru

Job Description

Job Title: Manager/Senior Manager - Provider Network
Location: Bangalore


Job Description

Job Purpose
Responsible for creating and managing in house network for IPD, OPD for the zone/region.
The candidate will be required to liaise with hospitals/nursing homes on daily/periodical basis with objective of facilitating and managing business relations.
She/he will also be required to liaise with corporate partners/brokers in their region in order to see the smooth functioning of claims processing and Network Management
Reports to Head Provider Network
Team Reporting Yes


Key Responsibilities & Accountabilities
Liaise with hospitals/nursing homes on a daily/periodical basis
Be an interface between the hospitals and companyclaims/customer service team
Ensuring tie ups with in stipulated time frame
Provider contracting and tariff negotiation on the best available rates
Responsible for overall activities related with empanelment of hospitals/nursing homes
Updating records and network presence intermittently
Periodic audit of Network providers/TPAs with random onsite visits
Works in co-ordination with the providers to ensure superior health care delivery at hospitals
Ensure adequate measures are in place to identify fraudulent activities at providers and take timely action

Knowledge/ Experience / Skills
Experience in provider contracting
Strong proficiency with MS Excel and MS Power point
Previous experience of managing provider network with Health, General Insurance co./TPA
Familiarity with key hospital management team
Health care market intelligence
Graduate with Insurance knowledge and understanding of IRDA guidelines and compliance
Excellent oral and written communication
Customer service skills
Negotiation Skills
Insurance Operations

Behaviours/ Competencies
Highly results oriented and driven to succeed
Highly ethical and value driven
Proactive, agile and highly responsive towards achieving goals - leveraging key strengths and capitalizing on opportunities with a keen sense of urgency
Strong interpersonal skills, able to successfully build and maintain networking relationships (both formal and informal)
Continuously strives for excellence and improvement

Keyskills

Desired Candidate Profile

Please refer to the Job description above

Company Profile

TopGear Consultants Pvt Ltd.

Leading Recruitment Firm
View Contact Details+

Recruiter Name:Ritu

Contact Company:TopGear Consultants Pvt Ltd.

Email :ritu@topgearconsultants.com

Website:http://jobs.topgearconsultants.com

Salary

Not Disclosed by Recruiter

Industry

Insurance

Role Category

Operations/Processes

Role

Claims Manager

Employment Type

Full Time, Permanent