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Process Manager - Medical Management Domain

8.00 to 11.00 Years   Mumbai City   05 Apr, 2023
Serving Skill
Job LocationMumbai City
EducationNot Mentioned
SalaryNot Disclosed
IndustryRecruitment Services
Functional AreaOperations Management / Process Analysis
EmploymentTypeFull-time

Job Description

    To Manage customer experience during the medical journey & drive Operational Excellence by way of introducing new technologies, customized communication and medical scheduling processKey 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-timeSpecific Authorities( Financial & Non Financial) :- Authorized to approve medical escorting / HNI center cost- Authorized to approve specific vendor paymentsKey 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 disciplineExperience - 8 to 12 Yrs. preferably in Life Insurance IndustryFunctional Competencies :- MS Office Suite- Regulatory knowledge- Process, Product & System Knowledge- Analytical SkillsBehavioral Competencies:- Building Talent and Teams Definition- Collaboration- Execution Excellence- Customer CentricityKey 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 BucketRisk and compliance :- To resolve queries related to Risk and compliance requirementRisk and compliance:- To resolve queries related to Risk and compliance requirementExternal:Nature or purpose of interactionAuditors:- To independently Handle Audit Observations & ensure fixes of the gaps identified TPA- To manage TPA for the entire medical process,

Keyskills :
managementcustomer servicedeliverycustomer relationsmis

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