This role oversees claims registration and payment operations, ensuring timely, accurate, and compliant processing. It manages vendors and TPAs, monitors SLAs, and leads process improvement and digital transformation initiatives within claims operations.
- Vendor & TPA Governance
- Performance Monitoring: Establish and manage a structured performance management framework for External Vendors and TPAs, focusing on service quality, SLA adherence, cost efficiency, and compliance.
- Agreement Management: Review vendor contracts and implement monthly tracking mechanisms to ensure all external partners uphold professional standards.
- Contract Review: Conduct regular reviews of External Vendors and TPAs agreements and implement a monthly tracking mechanism to monitor performance and compliance.
- Tender & Renewals: Manage the full end-to-end process for open tenders, new applications, or contract renewals for External Vendors and TPAs.
- Strategic Project Leadership
- Act as the project lead for Claims Transformation initiatives, focusing on automating manual workflows and integrating new technical capabilities (e.g., e-payments or digital registration).
- Identify gaps in the current claims journey and lead cross-functional projects to modernize the claims infrastructure
- Process Innovation & Business Improvement
- Explore and implement new approaches to the business operating model to exceed customer expectations while ensuring a commercial return.
- Drive a continuous improvement culture by re-engineering workflows in the registration and ancillary services sections to optimize team capacity.
