UnitedHealth Group - Vice President - Networks - MBBS

Key responsibilities:

- Plan, implement and align networks resources to deliver exemplary networking benefits to internal and external stakeholders for Provider Onboarding, Provider Quality monitoring, Cost appropriation, Value adds, Network operational metrics and improving customer experience.

- Collaborate with functional leaders to understand and align deliverables to external stakeholders to maintain open lines of communication and to identify business opportunities

- Build and develop effective relationships with key decision makers in hospitals and diagnostic centers

- Ensure that regulations and guidelines related to provider networks is adhered to

- Set metrics, monitor provider performance and implement improvement plans

- Communicate provider updates to internal and external stakeholders to assist in evolving strategies

- Represent UHC in network related forums and meetings with insurers, clients and regulator

- Monitor provider payout TATs and processing accuracy and work with relevant internal teams to minimize potential financial liabilities, if any

- Conduct performance reviews, periodic feedback and hiring activities for the department

- Provide regular updates on planning, deliverables, gap rectification and recommendations to functional leaders and senior management.

Primary internal stakeholders:

(Within organization)

- Operations, Sales, Account Management, Customer service, IT, Finance, Legal, Admin

Primary external stakeholders :

(Outside organization) Insurers, Corporates, Brokers

Regulator

Hospitals and Diagnostic centres

Required experience & skills: (Qualification/Experience/Target industry/Skills set etc)

Medical Graduate - MBBS

- 10+ years in Health/Life Insurance/TPA/Hospital/Wellness fields

- Working knowledge in insurance principles

- Prior experience in Insurance networking and/or claims operations is an added advantage

- Knowledge of Hospital networks and respective management teams is an added advantage