Shriram Life Insurance - Senior Manager - New Business Operations

Description:

Job Description: Sr. Manager - New Business Operations

Position: In charge New Business Operations

Designation: Sr. Manager

Department: Operations

Sub-Department / Vertical: New Business

Location: HO

Reporting Manager: Head - New Business Operations

Direct Reports:

Deputy Manager, Executives (Team Size: 3 to 4)

Role Summary:

Purpose:

- Candidate will be responsible for working with medical TPAs to execute medical testing operations for SLIC. The role holder is also responsible for managing tele / video calling operations for the Underwriting function for underwriting / fraud detection, medical test feedback, grievance, agent verification etc.

- Supervising the tele / video calling team is a crucial responsibility. The role holder must also ensure that MIS & reports for relevant stakeholders are published as per prescribed formats & timelines. Process of medical registrations across all center processing, digitizing the process, along with that standardization of New business processing and other operational activities.

Role Requirements:

Education:

Degree in any discipline (Operations / Business Management)

Experience Range: 5 to 8 years

Professional Experience/ Skills:

- Prior experience in Medical TPA management for Life Insurance sector

- Must have basic knowledge of Underwriting guidelines & norms

- Must be able to supervise a small team

- Must have a strong process orientation

Key Responsibilities:

TPA Management

- Establish and manage relationships with Medical TPAs (e.g. Mediassist, Health India) for outsourced medical testing operations; Execute / renew contracts with TPAs after negotiating costs and agreement terms in coordination with the Legal team

- Set-up, define and communicate SLIC SOPs and guidelines for medical testing operations to TPAs; Ensure SLAs and activity wise TATs are clearly understood and agreed by TPAs

- Review and finalize mapping of empanelled Diagnostic Centers in coordination with TPAs; Ensure availability of medical testing facilities for all SLIC branches / locations

- Review and monitor TPA service levels and adherence to SOPs on a continuous basis; Ensure TATs for medical registration, uploading medical reports, submission of original reports etc. are maintained

- Plan and organize Mystery Shopping audits at Diagnostic Centers in coordination with branches / divisional offices; Review audit feedback regarding quality of service, adherence to SOPs and escalate issues / lapses with concerned TPAs

- Review and monitor medical pendency cases across branches / divisional offices / channels; Drive closures of pending cases through active follow ups with branch / divisional offices and TPAs

- Review and validate TPA invoices, obtain payment approvals and coordinate with Accounts for processing payments; Ensure all payments are disbursed accurately and on time

Manage Tele / Video Underwriting Operations

- Establish, set-up and revise SOPs, checklists and scripts for tele / video calling processes (e.g. underwriting / fraud detection, medical test feedback, grievance, renewals, agent verification)

- Collate cases from Underwriting team and plan work allocations to effectively manage tele/ video calling volumes

- Allocate cases and share case data dumps to team members for various calling processes (e.g. underwriting / fraud detection, very high risk, medical test feedback, grievance, agent verification)

- Ensure completion of daily calls and updation of forms / questionnaires in adherence to SOPs and defined timelines; Conduct random audits / checks to monitor quality and effectiveness of tele / video calls conducted by team

- Report and discuss negative findings / fraud cases with Underwriting team; Analyse fraud cases to identify common patterns / trends and provide inputs for revising underwriting norms & guidelines

MIS, Reports & Data Analytics

- Ensure MIS and reports (e.g. medical pendency, case status trackers, TPA adherence to TAT etc.) are prepared and circulated to internal and external stakeholders (e.g. branches / divisional offices / channels / TPAs) as per prescribed formats and timelines

- Perform data analytics and mining to generate insights regarding risk factors, negative locations, DC feedback etc.; Report and discuss findings with Manger to take appropriate preventive actions to mitigate SLICs risks

Support IT Projects & Audits

- Coordinate with the IT team for new system / module developments, change / enhancement requests and UATs pertaining to the Underwriting function

- Provide data support for all audits (internal, IRDA) and respond to all audit queries and clarifications raised

Team Management

- Set clear expectations by communicating Tele / Video calling objectives, guidelines, SOPs and timelines to team members. Review performance of team members and provide on-going feedback

- Train the team on conducting effective tele / video calls, identifying & detecting frauds etc.; Provide guidance to team on specific cases, queries and escalations