Tata AIA Life Hiring for Assistant Manager- Medical Management Team (Quality) Job at Thāne Full Time

Department : New Business – Medical Management Team

Level/ Band :

Qualification : Doctor

Experience : Life Insurance background and work Experience in the Insurance Industry .Managing TPA and medical profile specially with Quality background –minimum 3-5 years of experience, Good Excel & PPT Knowledge.Able to manage support team

Role Summary :

• Dr from Clinical and Insurance domain knowledge
• should be familiar with medical terminology used in Pre-policy medical process in Insurance
• Technically sound on Insurance medicines
• To uphold Quality in medicals performed by TPA
• Should be able to conduct trainings for TPA staff and conduct certification for them
• Should be able to manage medical complaint cases and do RCA and solution to the betterment on processes
• Good communication skills as need to directly connect with customers in some challenging cases or basis request from Stake holders
• Excel and PPT skills
• Need to conduct diagnostic center audits through service providers
• Should have hands on experience in managing medical process i.e. Quality, Technical know-how, TPA co-ordination by taking training / Review on medical aspects

Reports to Manager /Sr. Manager

Supervises :: Yes

Geographic Area Covered

Stakeholders Internal : UW, New Business, IT, BSG, Branches, Channels

External : Vendors

Key Result Areas

• Should belong from Insurance domain knowledge specially Medical Management

• Should be from Science background from educational perspective and should be familiar with medical terminology used in Pre-policy medical process

• Should have hands on experience in managing medical process i.e. Quality, Technical know-how, TPA co-ordination by taking training / Review on medical aspects

• To uphold Quality in medicals performed by TPA

• Should taking various training programs, test of the TPA staff and keep them updated on quality perspective.

• To have industry knowledge on medical handing processes.

• To explore new processes basis past experiences which will help to create robust process flows

• Should be a Team player and should be able to work on different RCA, ability to manage MIS Trends and presentations

Competencies

Competency For

Proficiency Scale

Proficiency Scale Description

Customer and Consumer Focus : Customer and consumer Focus is about adding value to all customers, internal and external, through thought, action & . Adding value implies understanding the customer needs vis a vis the market, and being committed in delivering solutions that delight the customer and consumer and enhance the relationship without compromising on company SOP’s and values.

Analyzes the market trends, anticipates customer needs and adopts the best solutions that will exceed the customer Expectations while meeting organizational SOP’s. Stretches self and team to deliver customer delight Goes out of the way to deliver on time, the commitments made to the customers and consumers while striking a balance between their needs and organizational SOP’s. Guides team members to build relations And ensure customer delight.

Functional Skills and Ability : Ability to gain new knowledge/ skill/ information, analyze the risks associated with the same and take timely decisions, as per the set processes and regulations, while constantly Meeting quality standards .

Takes efforts to gather market information from multiple sources. Has a broad understanding of the financial / commercial factors and dynamics important to the business. Gathers and evaluates information to take decisions which will enhance the effectiveness of the department. Pursues opportunities with optimal risks that can lead to substantial benefits. Displays dedication towards quality improvement and on-time delivery for self and team

Proactively updates oneself on business trends and regulatory changes and understands their impact on the organization. Uses developments in the business/ industry domain to develop long-term business or functional goals. Makes decisions/ policies considering factors such as cost, benefits, risks and buy in. Guides the teams to follow processes and regulatory guidelines so as to continuously strive towards delivering exceptional high quality solutions.

Building teams and Engaging People

Encourages and leverages diversity by utilizing individual strengths and actively builds teams with complementary skills. Makes team members understand criticality of their contribution to the team’s success. Provides constructive feedback and rewards and recognizes all contributions..

Advices and coaches others by sharing experiences and discussing how to handle current or anticipated concerns. Communicates openly, builds trust and treats all team members fairly, ethically and as valued allies. Recognizes the value of the workforce, delegates tasks and empowers team members so as to fully utilize their potential.

Performing Under Pressure Deals with ambiguity and proactively makes effective decisions even in the absence of clear directions to drive high performance from self and team. Treats change and new situations as opportunities for learning or growth.

Maintains high levels of enthusiasm and passion within teams/units even in the face of adversity.

Drive for Results Motivates team members to set stretched goals, prioritizes tasks and leverages all available resources to deliver high quality timely results.

Shows a significant level of effort, persistence and time commitment to achieve the goals. Ensures self and team understand the urgency of work and takes accountability.

Underwriting

Sets stretched goals for self and others. Continuously motivates team members to demonstrate passion and drive to achieve the results and take accountability for the same. Facilitates goal accomplishment by planning and monitoring work, anticipating possible obstacles and making process enhancements to achieve team goals