2070Health - Compliance & Empanelment Lead - LLB

Role Overview:

- We are looking for an experienced and detail-oriented Compliance and Empanelment Lead to join our team at 2070Health.

- This role will play a critical part in ensuring that our healthcare initiatives comply with all relevant regulations and standards while also managing and optimizing the process of empanelment with service providers and partners. You will work closely with various stakeholders to develop and implement compliance strategies and frameworks that align with our organizational goals.

Compliance:

- Ensure adherence to all statutory, legal, and regulatory healthcare compliances applicable to hospitals

- Maintain accurate records of agreements, licenses, and statutory renewals

- Coordinate with legal advisors and external authorities for audits, inspections, and assessments

- Monitor compliance across departments and raise red flags for any deviation

- Draft and review MoUs, contracts, and documents related to empanelment and partnerships

Empanelment Management:

- Drive and maintain empanelment with TPAs, corporates, PSUs, CGHS, ECHS, ESI, and other government/insurance bodies

- Handle documentation, applications, follow-ups, and negotiations for new empanelments and renewals

- Liaise with billing and recovery teams to ensure smooth claim settlements

- Maintain updated rate lists, terms of empanelment, and communication logs

- Work closely with hospital marketing and billing teams to improve patient footfall through empanelment channels

Recovery & Reporting:

- Track payment cycles and ensure timely follow-up with TPAs for claim settlements

- Support in preparing monthly MIS reports on empanelment status, recovery, and pending dues

- Coordinate with internal finance and audit teams on claim discrepancies and rectifications

Key Skills & Competencies:

- Strong understanding of hospital operations, TPAs, and regulatory frameworks

- Effective communication and negotiation skills

- Detail-oriented with strong documentation and organizational skills

- Ability to coordinate across departments and manage external relationships

- Knowledge of healthcare billing and audit processes

Qualifications & Experience:

- Bachelor's degree; LL.B preferred.

- Minimum 8-10 years of experience in empanelment, legal compliance, or hospital liaison roles

- Prior experience with multispecialty hospitals or TPA/insurance sector is highly desirable