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Aditya Birla Capital Limited
Aditya Birla Capital Limited (“ABCL”) is a listed systemically important non-deposit taking Non-Banking Financial Company (NBFC) and the holding company of the financial services businesses. ABCL and its subsidiaries/JVs provides a comprehensive suite of financial solutions across Loans, Investments, Insurance, and Payments to serve the diverse needs of customers across their lifecycles. Powered by over 63,750 employees, the businesses of ABCL have a nationwide reach with over 1,712 branches and more than 200,000 agents/channel partners along with several bank partners.
Nationwide Branches
1,712
No. of Employees
63,750+
Agents/Channel Partners
2,00,000+
Aggregate Assets
INR 5.50 Lakh Cr
Active Customer Base
39 Million
Consolidated Lending Book
INR 1.78 Lakh CrCorporate Governance Policies
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Job Description
RM - PN Surat
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Job Description
| Basic Details: Fill the required information about business, unit, location, position, reports to position and date of updation of JD |
Business | Health Insurance | ||
Unit | Aditya Birla Health Insurance Company Ltd | ||
Location | ABHI - Bangur BFL Estate, Kolkata | ||
Poornata Position Number of the job |
| Reports to: Poornata Position Number |
|
Poornata Position Title of the job | AM – Provider Network | Reports to: Poornata Position Title | Zonal Head - Provider Network |
Function | Services Operations | Reports to: Function | Services Operations |
Department | Operations - Provider Network | Reports to: Department | Operations - Provider Network |
Designation of the Employee | Asst. Manager – Ops Provider Network | Designation of the Manager | Senior Chief Manager |
Date of writing/updation of JD | 5-Jan-24 |
| 1) Job Purpose: Write the purpose for which the job exists (in 2-3 lines) |
The role will be responsible for network data management, system preparedness, tripartite agreement management, preparing various daily, monthly & quarterly MIS, cost & tariff analysis. The role will be responsible for assisting the zonal contracting team to manage the renewal & tariff negotiation with hospital based providers, management of agreement & on boarding the providers while ensuring compliance as per regulator directives. |
| 2) Dimensions: Mention quantitative or qualitative parameters that are relevant for the job and provide a better understanding of the scope and scale of the job. | |
Business Workforce Number | On Roll – 6000+ Offroll/ Part time – 4000+ |
Unit Workforce Number | On Roll – 6000 Offroll/ Part time – 4000+ |
Function Workforce Number | On Roll – 800 Offroll/ Part time - 279 |
Department Workforce Number | On Roll – 16 Offroll/ Part time - 4 |
Other Quantitative and Important Parameters for the job: Budgets/ Volumes/No. of Products/Geography/ Markets/ Customers or any other parameter |
|
| 3) Job Context & Major Challenges: Write the specific aspects of the job that provide a challenge (internal and external) to the jobholder in the context of the Business/Unit/Function/Department/Section | |
About the Health Insurance Industry –
While the current market sees more than 15 non-life players in the private space and 5 exclusive private players in the health insurance space trying to capture a sizable market share, the nationalized service provider (6) remains a strong competitor. In addition to this the business dynamics are such that the overall market on an annual basis which is to the tune of roughly 10,000 Crs sees close to 85 % of the business renewing with the existing service provider itself. This narrows down the opportunity of the fresh business actually being seriously fought in the market to approximately 1500 odd Crs. With the SME and the start-ups being the driving force of Indian economy, the opportunity to cater to these segments is immense and is increasing manifold year on year. The challenge here therefore remains as to how we capture a larger share of the opportunity by developing specific solutions to cater each segment of the business. Also by creating an inexpensive and standardized solution to increase the reach into the pockets of channel partners across the country to harness on their captive business and explore new opportunities with them.
Market Opportunities – With the advent of medical advancements, lifestyle changes, change in Indian socio-economic scenario and Indian healthcare space, and the insurers are facing challenges to cater to the needs of this diverse clientele. Increasingly Indian customers have started considering health insurance partners as extensions of health advisers. In this scenario it becomes extremely important to understand their psyche and then provide tailored solutions with wellness benefits which would help them meet their end objectives and bring in profitable revenue source for the company.
About the Aditya Birla Health Insurance –
Aditya Birla Health Insurance Co. Limited (ABHICL) was incorporated in 2015 as a 51:49 joint venture between Aditya Birla Capital Limited (ABCL) and MMI Strategic Investments (Pty) Ltd. ABHICL commenced its operations in October 2016. ABHICL has entered the competitive health insurance market with an aim to expand the category to wider customer segments, beyond the ones that health insurance companies traditionally have marketed to. As the 6th entrant in a category with well-established players, ABHICL is creating differentiation and equity for itself though the unique business proposition of “Health Insurance for All”, a one of a kind proposition in India at the moment. This is a philosophy that is being built through every single consumer touch point and into every single backend process of the company to ensure a customer’s experience of our proposition is continuous and seamless. ABHI’s unique offering to market includes proposition includes -
Role context:
Aditya Birla Health Insurance Co. Ltd. which started operation in 2016 having its corporate office in Mumbai and having potential to develop a vast customer base in the region. Hence developing a network of Healthcare Providers both hospital & non-hospital based providers & maintaining relationship with provider in line with its objective to provide seamless healthcare experience to its clients is one of the primary responsibility. While creating the network is important, data & operations management for the same also holds paramount importance. Regular data analysis & meaningful MIS will help achieve the overall objective of being cost efficient.
As Central Operations, the person has an overall responsibility of network data management, system preparedness, tripartite agreement management, preparing various daily, monthly & quarterly MIS, cost & tariff analysis. The person needs to assist the zonal contracting team to manage the renewal & tariff negotiation with hospital based providers.
Challenges –
|
| 4) Key Result Areas: Write the key results expected from the job and the supporting actions for each of these key result areas (For a majority of jobs typically there could be 4- 7 key result areas) | |
Key Result Areas | Supporting Actions |
Provider Servicing and Data Management |
|
System Preparedness |
|
Co-ordination with TPA and Claims Function |
|
MIS Preparation |
|
Legal and compliance
|
|
Cost & Tariff Analysis |
|
| 5) Job Purpose of Direct Reports: Describe the job purpose of the direct report/s to the job (in 2-3 lines for each report) |
Zonal Head - The role will be responsible for creating, developing & managing a comprehensive network of healthcare providers and partners across the Zone along with team members across assigned geography. The role will also be responsible to negotiate best tariff structure for ABHI and manage the renewals and relationships while being responsible for making sure delivery of quality services as per signed SLAs.
|
| 6) Relationships: Describe the nature and purpose of most important contacts or relationship (except superior/team members) with individuals, departments, organizations inside and outside of the organization, that job is required to interact with in order to deliver the job objectives | ||
| Relationship Type | Frequency | Nature |
Internal |
|
|
Claims Team
Customer Service Team
Pricing and Product Team
Sales Team
Digital and IT
| High
Low
Low
Low
High
| Ensuring cost efficiency through effective cost & tariff analysis
Resolving customer complaints and grievance through working with zonal contracting team
Helping in building right pricing assumption and validating the product ideas
Providing on ground support through sharing network sufficiency
Ensuring system readiness & publication of network data on company website & helping Claims Team in claim processing |
External |
|
|
Healthcare Providers
TPAs
|
Medium
High |
Sharing branding materials & onboarding the providers
Ensuring tripartite agreement signing as per regulator guideline
|
| 7) Organizational Relationships: Provide the structure for a level above and below the position for which this job description is written. Use position titles in the structured and indicate all the reports of the position. |
| SIGN-OFF: Provide the name of the Manager and the jobholder. Signature needed for the hard copy of the JD. Hard copy to be maintained in the organizational record. | ||
| Job Holder | Reports to – Manager |
Name |
|
|
Signature (needed for the hard copy) |
|
|
1 - 3 years
02 degree
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