Assistant Manager - Health Management

About the Role

This position is responsible for coordinating and planning operational activities within the health insurance domain, supporting the team to achieve organizational goals effectively.

Company Background

Aditya Birla Health Insurance Company Limited (ABHICL), established in 2015 as a joint venture between Aditya Birla Capital Limited and MMI Strategic Investments, began operations in October 2016. As a key player in India's health insurance market, ABHICL aims to broaden customer reach with a distinctive proposition focused on inclusive “Health Insurance for All.” The company emphasizes customer-centric, seamless experiences through innovative health and wellness programs and digital processes.

Key Responsibilities

• Manage high-risk patients by adhering to medical protocols, handling communications via phone, email, or in-person, and ensuring confidentiality.
• Develop and follow detailed tracking plans for disease management, addressing possible complications.
• Coordinate with internal departments and external stakeholders for efficient operations and issue resolution.
• Maintain service standards and protocols for the DRM (Disease Risk Management) team to ensure client satisfaction and retention.
• Identify operational risks, escalate issues appropriately, and contribute to refining guidelines and procedures.
• Collaborate with claims team on raised claims and provide timely feedback.
• Initiate process improvements and promote digitization to enhance efficiency.
• Create and deliver Management Information System (MIS) reports and dashboards with analysis and insights.
• Ensure compliance with regulatory standards, manage governance processes, audits, and payment leakages.

Challenges and Context

The role requires thorough knowledge of DRM processes and systems, managing TAT expectations, and continuous collaboration across multiple departments. The unique aspect of the job is contributing towards innovative health insurance solutions through proactive health management and digital transformation.

Key Relationships

The role involves constant interaction with internal teams such as New Business, Policy Administration, Legal, Sales, IT, Underwriting, Internal Audit, Provider Management, Product, Actuarial, and CRM. Externally, communication is maintained with policyholders and vendors primarily on an as-needed basis.

Additional Information

The position reports to the Deputy Chief Manager and operates within the Operations function of the Health Insurance business. The current job description update is from May 23, 2022. Proficiency in MS Office and Excel is essential.