Head - Payor - Corporate Sales & Business Development - TPA - Insurance

Objective

To establish the healthcare group as the preferred partner for payors and patients by creating an efficient Business Development model. The Head Payor will be responsible for building strategic relationships, streamlining engagement practices, and ensuring that the group is recognized for best-in-class clinical and operational outcomes while delivering a seamless experience to patients and role will lead the strategic payor engagement roadmap across the hospital chain, ensuring growth in revenue, market share, and patient trust. The timeline for execution will be defined based on a thorough evaluation of current engagement practices with both external and internal stakeholders, and aligned through a mutually agreed action plan with Stakeholders : Medical Specialties, Operations, Finance, Sr. Management Insurance & Corporate Teams.

External Stakeholders : Insurance Companies, Third-Party Administrators (TPAs), Aggregators & Broking Firms, Corporates & PSU Corporates, Government Health Schemes and Patients.

1. Preferred Partner Networks

• Identify key insurance partners and initiate strategic tie-ups based on geography and specialty demand.
• Build trust through transparent reporting, clinical outcomes, and satisfaction metrics.
• Demonstrate value via single-line billing models, day-care procedures, and value-based care (reducing ALOS).
• Conduct periodic outcome review meetings with payors.
• Establish the group as a centre of trust with excellent clinical outcomes within managed care networks.
• Ensure patient satisfaction scores & Net Promoter Score (NPS) with increase in empanelment & revenue.

2. Technology-Based Collaborations

3. Centralized Claims Management

5. Grievance Redressal & Troubleshooting

Qualifications & Experience

(ref : iimjobs.com)