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