Cluster Manager - PN (Chandigarh)
Cluster Manager- JD - Location: Multiple (West & South)
As a Cluster Manager of Healthcare Network & Operations, your typical week might include the following
As a Cluster Manager of Healthcare Network & Operations, your typical week might include the following
- Identify Healthcare Service provider partners include Hospitals, Doctors, Diagnostic centers / vision, and dental centers / home care treatment providers /allied medical service providers, and other partners that will add value in services for ABHI policy holders
- Deep understanding on Health care eco system & innovate ideas on service level engagements with Hospitals / Diagnostic centers / Clinic & Other service care providers
- Development and management of an adequate provider network in assigned geographical area
- Maintaining relationships and all provider relations activities in assigned geographical
- Analyze and understand Health Insurance industry and competitor landscape & Market intelligence on competitors
- Plan & execute Co-branding activities and bring brand visibility among the Service providers
- Support of Regional Network Team & implement industry best practices as required to achieve success for ABHI
- Negotiating and renegotiating contracts with physicians and Healthcare provider groups
- Monitoring of various reports to ensure all necessary compliance requirements are met and maintained
- Reporting to Zonal & leadership team on status, risks, and potential opportunities in area of responsibility on a regular basis
- Payment reconciliation, addressing Provider grievances & carrying our region wise MIS reports in responsible geographies
- Monitor, drive case management negotiations with Network hospitals in assigned geographies
- Able to identify, monitor fraud/abuse and leakage
- Able to effectively identify opportunities for repricing and renegotiations of the Tariff / Packages / Discounts with healthcare providers
- Willing to Travel across geographies and maintain relationship with healthcare partners
- Have a degree or a management degree (healthcare management is preferred)
- Have 6-8yrs exp in health insurance with at least 5+ years’ experience in leading provider network teams
- Have experience with developing provider networks from scratch
- Able to make quick decisions and have good judgment and analytical skills
- Have excellent verbal and written communication skills and strong negotiation skills.
- Always open to embracing change and be able to manage it
- Passionate about building highly engaged teams
- Are passionate about consumer behavior and culture; enjoy spending time with customers/providers to understand what they really want. Have an attentive ear listen to new ideas
- Thrive in environments that celebrate co-creation and collaboration
- Are passionate about leveraging digital tools to transform customer experience
- Like to work in a culture where everyone can see what others are doing
- Take help from others when stuck and encourage others when there are setbacks
- Take full responsibility for your team’s contribution while thinking wing to wing across the organization; to solve for the customer
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