Experience

RAKSHA HEALTH INSURANCE TPA PVT LTD.

• India
• Insurance
• 1 - 100 Employee

• Sr Vice President & Zonal Head

  • Apr 2020 - Present

  23 years of work experience with more than 15 years in Leadership role. Managing a team of 250 across multiple regions . Encourage positive thoughts , energetic work environment , collaboration among teams and execution of tasks. Always excited to work on new projects and learning new skills. Strategise for Business Retention and building relationships 23 years of work experience with more than 15 years in Leadership role. Managing a team of 250 across multiple regions . Encourage positive thoughts , energetic work environment , collaboration among teams and execution of tasks. Always excited to work on new projects and learning new skills. Strategise for Business Retention and building relationships



Raksha TPA Private Ltd.

• Insurance
• 200 - 300 Employee

• Vice President - Operations ( West region including Mumbai, Pune, Vadodara & Ahmedabad)

  • Nov 2006 - Present

  OPERATIONS - Leading business operations of 500 Cr mediclaim premium , managing a team of 150+ - Managing P & L by planning and strategizing business operations & Claim administration of the Health Insurance TPA ( Payor & Provider Management) for West region ( Mumbai, Pune, Vadodara and Ahmedabad) - HR function - Performance review through KPIs, recruitment , selection, training and development - Facility Management - Administration, infrastructure , statutory compliances - Contract & Vendor management - Customer Care - Grievance redressal both from external ( Insurance Cos, Corporates and Client engagement) and internal from intra departments - Network Provider management & Investigations - Relationship building with leading hospitals with Tariff negotiation, decision making on Fraud / abuse, decision making on key criterias for hospital selection & empanelment - LEAN management with cost control measures - Capacity utilisation with maximum efficiency - Finance - Budgeting, Monitor revenue cycle and out standings - Claim Adminstration - planning allotment and ensuring turn around time as per Insurance Co SLA - Data Analysis - Portfolio management for Insurance co and corporates , providing insight on outflows and suggesting methods on claim cost reduction CLIENT RETENTION - Leading Retail and Corporate business retention team . Presentation to Corporates and Insurance Companies and meeting the senior officials - Liaison with key decision makers in Insurance Co, Corporates for customer retention - Identifying health care needs of the Corporates and extending wellness and healthcare solutions through various service providers like hospitals and diagnostic centres Initiatives & Achievements - Instrumental in business retention & operations - Client retention rate 98% - Region business growth @ 23% y.o.y - Manpower restructuring for Lean methodology - Improved turn around time for claim operations - Structured MIS for better monitoring Show less



SRL Ranbaxy ( Super Religare Laboratories)

• Mumbai Area, India

• Section Manager

  • Apr 2003 - Oct 2006

  - Managing corporate clients, leading a team of 18 , staffing the departments, delegating work load , actively supporting employee growth and handling office operations - Identifying needs of various health check up packages and ensuring smooth customer delivery - Corporate MIS and analysis - Developing system integration with each health check department , handling grievance - Budget allocation and monitoring - Patient satisfaction survey From 2003-2005, responsible for Collection Center administration and co-ordinator for PAN India - Planning, strategising and feasibility for infrastructure, operations and financial projections for Collection centres - Development of new software requirements fro franchisees for smooth process - Quality Assurance ( including quality improvement tools, checklists, pre-analytical variables , audits, etc) - Single point of communication channel for collection centres Show less



Metropolis Laboratory

• Mumbai Area, India

• Administrative Incharge - Franchisees

  • May 2002 - Mar 2003

  - Budget the business development process and formulate the strategies - Identify prospective clients, maintain data base , regular follow ups and periodic analysis of the business development activities - Identifying various product mix and customising the packages - Developing, maintaining , co-ordinating and monitoring a support system to the logistics network - Quality audit of business development activities - Budget the business development process and formulate the strategies - Identify prospective clients, maintain data base , regular follow ups and periodic analysis of the business development activities - Identifying various product mix and customising the packages - Developing, maintaining , co-ordinating and monitoring a support system to the logistics network - Quality audit of business development activities



Ayushman Hospital

• Bhopal Area, India

• Manager - Administration

  • Jan 2001 - Oct 2001

  - Develop SOPs for process standardisation - Business correspondence with various corporates - Co-ordinate with software partner for computerisation of hospital systems - Developing and maintaining vital statistics for monthly and annual reporting - Management review programs for staff, restructuring manpower for better efficiency - Job descriptions and allocation of staff roles - Develop SOPs for process standardisation - Business correspondence with various corporates - Co-ordinate with software partner for computerisation of hospital systems - Developing and maintaining vital statistics for monthly and annual reporting - Management review programs for staff, restructuring manpower for better efficiency - Job descriptions and allocation of staff roles