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