Process Manager - Medical Management Domain - Life Insurance

To Manage customer experience during the medical journey & drive Operational Excellence by way of introducing new technologies, customized communication and medical scheduling process

Key Responsibilities:

Responsibilities :

- To Implement the Medical Process and UW guidelines on medicals

- To be a key participant of Service Team: Formulate strategy to match medical Experience to Customers' expectations

- To Bring in in new technologies to ensure frictionless medicals

- To Formulate mechanisms to control delivery as per agreed SLAs

- To Implement RCA and CAPA mechanism to identify and resolve Customer complaints

- To Ensure timely and accurate tracking and visibility on medicals to other stakeholders

- To Ensure adherence to scope of work and improving the performance of TPAs on business KPIs through regular reviews, reports and feedbacks.

- To work closely with Information Technology/UW/Issuance and Partners for systems development and/ or enhancements.

- To Co-ordinate in User Acceptance Testing and implementation of systems

- To Develop and manage outsourced vendors as may be required from time-to-time

Specific Authorities( Financial & Non Financial) :

- Authorized to approve medical escorting / HNI center cost

- Authorized to approve specific vendor payments

Key Performance Indicators:

- Medical Report closure in T+2wk days: 98%

- Medical report quality: 100%

- Login to Medical decision in 15 days: 90%

- Vendor Payout accuracy: 100%

- To Ensure NPS Score of =>75%

Job Requirements:

Qualifications: Graduate/ Postgraduate in any discipline

Experience - 8 to 12 Yrs. preferably in Life Insurance Industry

Functional Competencies :

- MS Office Suite

- Regulatory knowledge

- Process, Product & System Knowledge

- Analytical Skills

Behavioral Competencies:

- Building Talent and Teams Definition

- Collaboration

- Execution Excellence

- Customer Centricity

Key Interactions:

Internal:

- Nature or purpose of interaction

- Branch Operations/Sales teams/UW teams

- Interactions via email & calls for Medicals Scheduling & Reports closure IT Team

- Interaction for resolving any IT stuck cases & prioritizing closure of cases stuck in Medical Bucket

Risk and compliance :

- To resolve queries related to Risk and compliance requirement

Risk and compliance:

- To resolve queries related to Risk and compliance requirement

External:

Nature or purpose of interaction

Auditors:

- To independently Handle Audit Observations & ensure fixes of the gaps identified TPA

- To manage TPA for the entire medical process