Cluster Manager- JD - Location: Multiple (West & South)

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

You could be the right candidate if you

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

This could be the gig for you if you…

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

Cluster Manager - PN (Chandigarh)

Recommended Jobs