We are hiring Head of Insurance for a Leading Eye Healthcare Organization based in Delhi

Job Title: Head- Insurance (to manage insurance empanelment and claim settlement)

Location: Delhi

CTC: Up to 25 LPA

Experience: 10+ Years

Employment Type: Full-Time, Permanent

Department: Insurance Operations

Industry: Healthcare / Hospital

Role Overview:

The Head- Insurance is responsible for building, managing, and strengthening strategic relationships with insurance companies and Third Party Administrators (TPAs) to ensure seamless patient access, timely claim settlements, and continuous revenue growth. This role demands a professional who brings a unique combination of deep insurance industry knowledge and hands-on hospital experience, with the latter being the most recent. The leader will serve as the primary liaison between the organization and insurance ecosystem stakeholders, ensuring compliance, operational excellence, and sustainable revenue flow.

Key Responsibilities:

1. Strategic Relationship Management

- Develop and maintain strong relationships with senior leadership at insurance companies and TPAs.
- Negotiate empanelment terms, tariffs, and service agreements to ensure competitive positioning.
- Act as the central point of contact for any disputes or operational issues with payers.

2. Business Continuity & Revenue Assurance

- Ensure uninterrupted partnerships by proactively managing contract renewals, deliverables, and service standards.
- Identify new revenue opportunities through insurance expansion and strategic partnerships.
- Monitor and optimize claim settlement turnaround times.

3. Operational Excellence

- Standardize processes for pre-authorizations, billing, claim submissions, and denial management across hospital units.
- Train and guide frontline insurance desks to deliver consistent,



high-quality patient and documentation accuracy.
- Implement technology-driven solutions for claim tracking and analytics.

4. Compliance & Governance

- Ensure adherence to IRDAI guidelines, insurance contracts, and hospital policies.
- Maintain complete, auditable documentation for all insurance-related transactions.
- Stay updated on regulatory changes impacting health insurance and hospital empanelments.

5. Stakeholder Collaboration

- Work closely with hospital operations, finance, and medical teams to align insurance processes with patient care objectives.
- Partner with marketing teams to drive insurance-led patient acquisition initiatives.

Key Performance Indicators (KPIs)

- Claim settlement rate (TPA/Insurance).
- Growth in insurance billed patient volume.
- Reduction in claim denials and rejections.
- Strength and depth of insurance network relationships.
- Compliance scores in internal/external audits.

Ideal Candidate Profile: Experience & Background

- 10 - 15 years of experience in health insurance and hospital administration, with recent 3 - 5 years in hospital insurance desk/relationship management.
- Proven track record of managing empanelments, negotiations, and escalations with insurance companies and TPAs.
- Robust operational and financial acumen in insurance-related hospital processes.

Skills & Competencies

- Excellent negotiation and relationship management skills.
- Robust analytical skills with experience in claim data interpretation.
- High level of integrity, professionalism, and customer orientation.
- Ability to manage complex multi-stakeholder environments.
- Proficiency in MS Office and Hospital Information Management Systems (HIMS).

Qualifications

- Graduate in any discipline; MBA/PGDM in Healthcare Management, Insurance, or equivalent preferred.

For further details Call / WhatsApp Neelam (phone hidden)

📌 Head- Insurance For a Leading Healthcare Organization based in Delhi
🏢 GIST Management Solutions
📍 Delhi