1) Job Purpose: Write the purpose for which the job exists (in 23 lines)

The SLA Commercial Goverce Manager will be responsible for endtoend goverce of Health Tech Partners (HTPs) and ThirdParty Administrators (TPAs), ensuring adherence to contractual obligations, service level agreements (SLAs), commercial performance metrics, operational excellence, and regulatory compliance.

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 (Max 254 Characters)

On Roll 6000+

Unit Workforce Number (Max 254 Characters)

On Roll 6000

Function Workforce Number (Max 254 Characters)

On Roll 800

Department Workforce Number (Max 254 Characters)

On roll

Other Quantitative and Key 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

The role will oversee goverce of:

35+ Health Tech Partners (HTPs) providing OPD and Wellness services with a portfolio size exceeding 500 Crores.

10+ TPAs managing Group Health Insurance (GHI) business with an overall portfolio of approximately 3, 000 Crores GWP.

Monitoring key business parameters including Loss Ratio (LR), Average Claim Size (ACS), ficial performance, service delivery standards, and partner compliance.





The incumbent will serve as the central point of coordination between ABHI and partner organizations, ensuring effective goverce, performance management, audit readiness, and business reporting.

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)

Health Tech Partner (HTP) Goverce

- Manage goverce framework for 35+ Health Tech Partners providing OPD and Wellness services.
- Monitor adherence to agreed Scope of Work (SOW), SLAs, KPIs, and contractual commitments.
- Conduct monthly, quarterly, and annual goverce reviews with partner organizations.
- Review operational, utilization, commercial, and serviceperformance reports.
- Drive corrective action plans and continuous process improvements.
- Manage and monitor a portfolio exceeding 500 Crores.

TPA Goverce (Group Health Insurance)

- Manage goverce of 10+ TPAs servicing ABHIs Group Health Insurance (GHI) portfolio of approximately 3, 000 Crores GWP.
- Monitor SLA adherence across claims servicing, customer service, preauthorization, reimbursement, and policy administration processes.
- Review operational performance,



turnaround times, and quality metrics.
- Conduct monthly and quarterly business reviews with TPAs.
- Track implementation of agreed action items and goverce commitments.
- Ensure compliance with contractual, operational, and regulatory requirements.

Commercial Goverce Business Performance

- Monitor partnerwise commercial performance and ficial outcomes.
- Track and analyze key performance indicators including:
- Loss Ratio (LR)
- Average Claim Size (ACS)
- Utilization Trends
- Cost Efficiency Metrics
- Service Delivery Performance

- Identify adverse trends and recommend corrective actions.
- Support commercial discussions and strategic decisionmaking through datadriven insights.
- Collaborate with Fice and Business teams for performance reviews.

Monthly Business Reporting PL Monitoring

- Prepare monthly business performance reports for OPD and Wellness Lines of Business.
- Monitor portfolio performance against budgets, targets, and business plans.
- Develop management dashboards covering:
- SLA Performance
- Partner Scorecards
- LR Analysis
- ACS Analysis
- Claims Trends
- Utilization Metrics
- Business Growth Indicators

- Provide management insights and recommendations on portfolio performance and profitability.

Disclaimer : This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.

📌 TM-Provider Network Professional (Maharashtra)
🏢 Aditya Birla Insulators
📍 Maharashtra