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2070Health - Compliance & Empanelment Lead - LLB

2070Health - Compliance & Empanelment Lead - LLB

2070HealthMumbai, India
30+ days ago
Job description

Job Title : Compliance & Empanelment Lead

Location : Delhi / Mumbai (with potential travel to other expansion cities)

Experience Required : 5 - 7 years

Employment Type : Full-time

About 2070 Health :

2070 Health is India's premier Venture Studio, pioneering an innovation platform dedicated to building groundbreaking healthcare companies from the ground up.

We identify and seize disruptive opportunities within the healthcare sector, actively engaging in idea generation, day-to-day operations, and strategic decision-making to ensure the success of each venture.

Supported by W Health Ventures, we are shaping the future of healthcare innovation in India.

About Everhope Oncology

Everhope Oncology, backed by Narayana Health, W Health Ventures, and 2070 Health, is on a mission to transform cancer care by making world-class treatment more accessible, patient-centric, and closer to home.

With $10 million in seed funding, Everhope is building a nationwide network of oncology facilities, starting in Delhi and Mumbai, and expanding to 10 cities over the next three years.

By creating smaller, strategically located oncology centers focused on early diagnosis, daycare chemotherapy, and surgical oncology, Everhope is eliminating logistical and emotional barriers to cancer care for millions of patients in India.

If you are passionate about compliance, healthcare systems, and want to play a critical role in shaping the future of oncology in India, wed love to hear from you.

Role Overview

The Compliance & Empanelment Lead will play a pivotal role in ensuring all hospital operations comply with regulatory frameworks while driving empanelment with TPAs, insurance providers, and government health schemes.

The role involves managing licenses, handling empanelment documentation, resolving claim issues, and ensuring smooth recoveries, while also enabling patient acquisition through empanelment channels.

Key Management :

  • Ensure adherence to all statutory and regulatory requirements applicable to hospitals and oncology centers.
  • Manage hospital and clinical licenses including drug license, pollution control, biomedical waste, fire safety, lift NOCs, and AERB compliance.
  • Track and ensure timely renewals of all mandatory approvals and registrations.
  • Coordinate with legal advisors, auditors, and regulatory authorities for audits, assessments, and inspections.
  • Draft, review, and maintain MoUs, contracts, and other legal documentation.
  • Build and maintain compliance dashboards for leadership & Insurance Management :
  • Lead empanelments with TPAs, private insurers, GIPSA, PSU insurers, CGHS, ECHS, ESI, and other government health panels.
  • Manage empanelment documentation, application submissions, negotiations, and timely renewals.
  • Maintain updated databases of empanelment status, rate contracts, and TPA agreements.
  • Resolve empanelment queries, escalations, and support clinic operations teams in leveraging empanelments for patient inflow.

Recovery & Claims Management :

  • Track payment cycles and coordinate with TPAs and insurers to ensure timely settlement of claims.
  • Investigate and resolve claim discrepancies, rejections, and denials, ensuring maximum recovery.
  • Maintain MIS reports on empanelment progress, claim settlements, and outstanding dues.
  • Collaborate with finance and audit teams to support reconciliation and statutory audits.

    • Key Skills & Competencies :

  • In-depth knowledge of hospital compliance frameworks, empanelment procedures, and healthcare regulations.
  • Strong understanding of government health panels (CGHS, ECHS, PSU insurers, etc.) and private insurance processes.
  • Excellent negotiation, documentation, and stakeholder management skills.
  • Proficiency in claim processing, rejections handling, and TPA interactions.
  • Ability to coordinate cross-functionally with clinical, finance, legal, and operations teams.
  • High attention to detail and ability to thrive in a fast-paced, scaling healthcare & Experience :
  • Bachelors degree is mandatory; LL.B preferred.
  • 5-7 years of experience in hospital compliance, empanelment, or liaison roles.
  • Prior experience in multispecialty hospitals, oncology centers, or TPA / insurance companies highly desirable.
  • Exposure to hospital launches, licensing processes, and empanelment negotiations will be an added advantage

    • (ref : iimjobs.com)

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