GM - Medical Services/Health Admin

We are urgently Looking for GM-Medial Services for one of our client,who is providing third Party Administrators providing service to Health Insurance policy holders across the country.

Job location would be at Bangalore.

- Looking for MBBS with Post graduate qualifications in Health Administration/Hospital management.

- Total Experience of 10-14 yrs in healthcare or insurance industry

Job Profile:-

Process Management:

- Responsible for developing both annual and monthly objectives for Medical Service in coordination with the Organization’s objective.

- Strategic planning for network expansion/PPO expansion

- Hospital Relationship Manager with Top Hospital

- Design and deliver quarterly analytics of top hospitals to the leadership team

- Tariff Management

Audits:

- Specific High value claim audits

- Medical high value audits of hospitals and recoveries whenever indicated

Network Hospital Relationship Mgt:

- Periodic visits to Top hospitals

- Monitoring Hospital payments and reconciliation

- Monitoring Bills pending from hospitals

- Shortfall Management and Fraud Control

Team Management

- Regular Monitoring

- Periodic review and evaluation

- Motivation and team building

- Enforcement of Discipline

- Annual performance appraisal of the department

- Make sure the internal processes are maintained with fewer complaints.

- Grievances Handling

- Interdepartmental Coordination

Salary may go upto rs. 17 lakhs/Annum.

Interested candidates need to share their profile on ranjan@livecjobs.com