Job Title: Senior Manager Provider Network

Department: Provider Network Management / Hospital Relations

Reports To: Head / Director Provider Network & Operations

Job Purpose The Senior Manager – Provider Network will lead the expansion, governance, and operational integration of the health insurer’s hospital network. This role oversees end-to-end hospital participation, ensuring strict tariff compliance, service quality SLAs, monthly billing and reconciliation, and technology/digital readiness for seamless cashless processing.

Key Responsibilities

- Hospital Onboarding & Network Expansion:
- Oversee end-to-end onboarding and empanelment of hospitals, day-care centers, and diagnostic chains into the insurer's network.
- Lead strategic contracting, rate negotiations, and agreement renewals with hospital management and leadership.
- Tariff Compliance & Quality SLAs:
- Enforce hospital adherence to agreed-upon package tariffs, discount structures, and contract terms to control medical inflation.
- Monitor and enforce Service Level Agreements (SLAs) regarding cashless turnaround times (TAT), query responses, and care quality.




- Conduct periodic performance reviews and audit network hospitals to prevent billing inflation, unnecessary treatments, or fraud.
- Billing, Accounting & O/S Management:
- Manage monthly billing cycles, hospital claim submission reconciliation, and account settlements.
- Oversee outstanding (O/S) payment balances, resolve billing disputes, and ensure timely settlement to maintain solid hospital relations.
- Tech Readiness & Digital Integration:
- Drive hospital tech enablement—ensuring provider integration with the insurer's portal/API systems for digital claims, pre-authorizations, and real-time status tracking.
- Ensure hospital desk staff are trained on internal platforms for smooth digital document submission and cashless request workflows.
- Escalation & Cross-Functional Coordination:
- Act as the senior escalation point for unresolved query management, claim denials, pre-auth delays, and hospital grievances.
- Work closely with internal Claims, Medical Audit, Pre-Auth, and IT teams to streamline operational workflows

Thanks & Regards

Hariprasad

📌 Insurance Network Program Manager- Bangalore ,Mumbai ,Noida, Hyderabad (Bengaluru)
🏢 Medi Assist
📍 Bengaluru