Job Description
We are looking for a qualified and skilled Program Manager for Health Claims Operations.
Key Responsibilities :
• Manage end-to-end claim processes from intimation to discharge and settlement.
• Negotiate and finalize terms with hospitals and insurers on a case-by-case basis.
• Ensure team performance in terms of achieving TAT (Turn Around Time) and quality of processing.
• Manage key client relationships.
• Develop timelines, budgets, teams, and plans for given projects.
• Own the growth and profitability of the program.
• Ensure compliance and hygiene in the program.
• Conduct performance reviews and evaluate programs.
• Facilitate communication between relevant teams.
What are we looking for :
• Work Experience : 5-6 years experience in high volume process management; experience in health claim processing will be an additional advantage.
• Education Background : Graduate / Postgraduate (Clinical qualification will be a plus).
• Skills :
• Flair for managing clinical and non-clinical processes together.
• Good communication and negotiation skills.
• Ability to converse with hospitals' and insurers' clinical as well as administration teams.
• Good understanding of healthcare provider pricing.
• Analytical and critical thinking skills.
Key Responsibilities :
• Manage end-to-end claim processes from intimation to discharge and settlement.
• Negotiate and finalize terms with hospitals and insurers on a case-by-case basis.
• Ensure team performance in terms of achieving TAT (Turn Around Time) and quality of processing.
• Manage key client relationships.
• Develop timelines, budgets, teams, and plans for given projects.
• Own the growth and profitability of the program.
• Ensure compliance and hygiene in the program.
• Conduct performance reviews and evaluate programs.
• Facilitate communication between relevant teams.
What are we looking for :
• Work Experience : 5-6 years experience in high volume process management; experience in health claim processing will be an additional advantage.
• Education Background : Graduate / Postgraduate (Clinical qualification will be a plus).
• Skills :
• Flair for managing clinical and non-clinical processes together.
• Good communication and negotiation skills.
• Ability to converse with hospitals' and insurers' clinical as well as administration teams.
• Good understanding of healthcare provider pricing.
• Analytical and critical thinking skills.
💡 Quick Summary
Seeking a career-building opportunity? The Program Manager position is now open for candidates interested in the Health Jobs sector. This role in Ajmer offers a professional environment and growth potential.
Requirement Snapshot: Candidates should possess basic communication skills, a proactive attitude, and the ability to work in a team. Experience in Health Jobs is a plus.
