The operating mandate

The company administers health-insurance and benefit claims on behalf of regulated risk carriers and institutional customers. Its work may include member onboarding, authorisation, provider coordination, claim scrutiny, adjudication support, settlement workflow, fraud control, grievance handling and health-data processing. It does not determine the underlying insurance promise unilaterally, but its operating decisions materially influence whether a member receives timely, fair and understandable service.

The Board seeks a Non-Executive Director who can strengthen governance at the point where clinical information, policy interpretation, provider conduct, technology and financial incentives meet. The position calls for someone who understands that claims efficiency is not synonymous with claim suppression, and that fraud control must be exact enough to avoid creating systematic hardship for legitimate members.

The appointee will help the Board develop a durable service model in which operational accuracy, customer protection,



regulatory conduct and unit economics reinforce each other. The Director will be expected to challenge incentives, automation or contractual service levels that produce superficially attractive turnaround times while transferring unresolved work, documentation burden or financial distress to members and providers.

Nine accountability domains

Claims fairness and consistency. Oversee the translation of policy terms and benefit rules into operating decisions. Similar fact patterns should produce consistent outcomes, while genuine clinical differences remain capable of reasoned review. Denials, deductions and partial approvals must carry intelligible grounds linked to the applicable contract.
Medical judgment and escalation. Ensure clinical questions are reviewed by appropriately qualified professionals operating independently of volume or savings targets. High-consequence decisions, unusual treatment paths, emergency ca

📌 Non Executive Director (Bengaluru)
🏢 Gladwin International
📍 Bengaluru