Job Description

Position:

Assistant Manager

Industry:

Health Insurance/TPA

Preference:

Male / Immediate Joiner

Roles & Responsibilities of Hospital Network Management- Asst Manager:

u Identify and empanel hospitals, clinics, diagnostic centers, and other healthcare providers to join the network.

u Maintain hospital network master with clean data and appropriately flag suspected hospitals

u Evaluate the quality of healthcare providers based on accreditation, facilities, and medical staff credentials.

u Negotiate contracts, package rates and discounts with healthcare providers to ensure competitive pricing while maintaining quality standards.

u Build and maintain strong relationships with hospital administrators, medical directors, and key stakeholders to facilitate seamless cashless claims management

u Coordinate and help cashless team in the events of disputes at the time of admission/discharge of members regarding billing by hospital

u Address and resolve any issues or concerns raised by network providers promptly and professionally.

u Ensure that the network hospitals comply with relevant state & central govt registrations and accreditation requirements.

u Stay updated with changes in healthcare policies and regulations that may impact the network.

u Analyze network performance data and generate reports for management to assess the network's effectiveness and make informed decisions.

u Close coordination with insurers on the network hospital management including empaneling hospitals as per the requirements of insurers.

u Managing the team working for network hospital management across locations.

u Constant monitoring of hospitals claims outstanding and coordinate with respective internal stake holders for payment of claims

u Close coordination with claims team on fraud and abuse control and initiation of appropriate action against hospitals involved in malpractices.

Assisting Provider Network Management Head in maintaining the provider master in the core application.

Job Types: Full-time, Permanent

Pay: ?35,000.00 - ?40,000.00 per month

Benefits:

Health insurance Provident Fund
Schedule:

Day shift
Work Location: In person