Geeta Udyawar
Healthcare Management
Mumbai
Summary
To obtain a position which utilises my skills in your organization, to work in a fast paced, professional and competitive environment that can harness my skills and allow me to be a part of its vision and helps me in growing along with it. Summary: Armed with both expertise and experience, I am confident in my ability to create. I am always learning and growing with the industry. As new trends have come and gone, I have evolved as a professional and learnt to innovate for the times. My experience spanning more than 19 years has taught me to perform efficiently under extreme time constraints and defined processes to produce quality output. My strength lies in my ability to solve comprehensive problems, desire to learn and blend feedback from a number of different sources (both internal & external customers) into an excellent customer service. My creativity as a professional emerges from the aptitude to think innovatively, from my being a good listener, having a good eye for aesthetics and a solid understanding of the needs of the corporate world.
Overview
20
20
years of professional experience
21
21
years of post-secondary education
1
1
Language
Work History
AVP of Operations
HealthAssure Pvt Ltd
Mumbai
2013.08 - Current
- Network and Strategic Partnership and Operations, Network and Strategic Partnership as a Founder Member for
- Team, aimed at robust process to be built focusing on quality network formation instrumental in expanding business alongwith Organizations branding at a PAN India Level
- Based on the effectiveness on Structures built on Network front for 8 yrs, was moved to Backend Operations which is based on Customer focus and requirements
- Empanelment of MSP’s on Panel of HealthAssure PAN India basis –
- Evaluate the documents based on set parameters, Analyse the need and Empanel Quality medical service providers on direct panel of BSLI for conducting Pre-Policy Insurance check-up of prospective clients
- Strategic Partnership –
- On-boarding of Premium Centres post negotiation on rates which resulted into cost efficiency for
- Organisation
- Managing the Risk Verification –
- Periodic survey of the quality of the Medical Centres, measure them on various parameters and based on the rating, refer the defaulters / erring Centres and taking corrective steps of either retaining or delisting the service Providers
- Timely Payments to Authorised Vendors –
- Ensure regular & timely payouts to authorised service providers
- Also conduct Reconciliation of payments and address queries of the Service provider upto their satisfaction
- Grievance/Claim Handling –
- Co-ordinating with the service providers for resolution of Grievances w.r.t missing / discrepant information in the reports and thereby facilitate Insurer’s for policy issuances
- This also includes investigation of Claim cases and sharing evidences with Insurer supporting them to facilitate decisioning on cases
- Camp Management –
- Management of Onsite Camps for Premium companies likes of Deloitte with around 3000 footfalls in time span of 6 days
- Also, ensuring Medical reports are triggered
- Working on System Enhancements in synergy with the IT team, system testing under various projects in development region and thereby moving it to production
- Projects Handled:- Payout system leading to reduction of manual errors in terms of manual monthly payment calculation
- Automated Payout emailers to Medical centres on release of Payments with the details of deductions and Customer wise details
- Enhancement in Empanelment modules by addition of Key Parameters based on requirement received from Insurer
- Automated real-time MIS for all such requirements received
- Grievance handling Module with a real-time departmental Output helping to track on grievances received and its closure with TAT
- System development for Effective Camp Management and driving the same seamlessly
- Development of Provider Portal Network leading to seamless flow of medical report into
- HealthAssure system with efficient flow of same into Quality check directly
- With a rich experience of 8 yrs in Network and Strategic Partnership was moved into Back-end
- Operations effective 1st
- July’ 2021
- Job Profile:
- With movement into Back-end function role got an opportunity to lead vertical of approx
- 60
- Employees reporting directly and indirectly as one of the core part of service in Operations
- The team managed currently is Show no show, team responsible to convert the appointments by checking with Medical centres and Customers, Report Pending will looks into retrieval of medical reports from medial centres, Quality Analytics and grievance redressal gatekeepers for insurer, Closing team who ensures that reports reaches Insurer’s as per TAT and also as per their requirement, OCR
- Team manages to have values ported into the system, the outcome of which can be utilised by
- Organisation for building up new Products, Hardcopy team who takes care of report retrieval from
- Medical centres in Physical form and sharing with Insurers as per agreed timelines
- Management of Show No Show -
- Team manages Show No Show status of Cases assigned to them ensuring targeted % is reached which adds to daily volume of business on PPMC front
- Report Pending-
- Ensuring to retrieve reports from Medical centres alongside maintaining the Targets and TAT set by the Insurance co
- Quality Analytics -
- All the reports retrieved from Medical centres are passed through team of Quality Check
- Analysts, thereby ensuring the completeness and correctness of reports
- These Gatekeepers act as risk mitigating team as well to some extend to Insurance co
- For Underwriting decisions
- OCR –
- All the medical reports received are run through the OCR system where test values are captured and the Output in excel is utilised by Organisation for creating new Market Products
- Hardcopy –
- Retrieval of Medical reports from Medical centres and sharing with the Insurance co
- Fortnightly or Monthly basis as per their requirement and purging data at our end
- Projects Handled:- Auto Closures of Medical report in System, 70% of medical reports are auto closed in system without any Manual Intervention
- Development and Management of BIS(Backend Integrated screen), one of its kind system wherein 3 processes are merged together to have a focused Medical centre approach
- Development of Videography Model for Inhouse Phlebos
Assistant Manager
Health India TPA Pvt Ltd
2011.03 - 2013.08
- In HO Operations/Mumbai managing end to end processes for
- Mumbai, west Zone and leading team of 12 Team Members
- Based on Efficiency, Performance and experience was moved to Provider Network
- Management(PNM)
- Empanelment of MSP’s on Panel of Health India PAN India basis –
- Key Result Areas:
- Creation of Automated MIS View to Insurer Companies providing real time update on their business
- Enhancement of existing Provider Network Management with an automated MIS of Daily request received, Pending requests with reasons and Completed request
- Real time update to Insurer on the Empanelment request placed by them.
Executive
Birla Sun Life Insurance Company Limited
2006.12 - 2010.09
- Back Office Operations-Team Underwriting-Medical Section
- Job Profile:
- MIS Handling and Publishing Management Dashboards –
- End to End Management of Third Party Administrator(TPA) –
- Managing the Risk Verification –
- End to end Management of Overseas Medicals –
- Timely Payments to Authorised Vendors –
- End to End Management of Vendors / Service Providers –
- Grievance Handling –
- Empanelment of MSP’s on direct panel of BSLI –
- Headcount Management & Costs Benefit Analysis –
- Working on System Enhancements in synergy with the IT team, system testing under various projects in development region and thereby moving it to production
- Projects handled include – o System interface between BSLI & TPA for enhancing customer satisfaction o Decentralization of medical report receipt from the branches o Automated Process Management (Paperless environment) o Auto trigger of medical requirements in APM o Automation of Daily MIS on TPA cases to PAN India Branches for case-wise status updates
- Prompt resolution of queries received from Internal/External Clients.
Executive
Bhaichand Amoluk Insurance Co. Pvt Ltd
2003.12 - 2006.02
- Front End Operations as well as Back End Operations
- Job Profile:
- Joined as an Team Member in Opeations team managing End to End processing of request received from Clients/Insurer
- Based on capability and efficiency in initial role, it was further extended to Payout management to Medical Centers
- Appointment Scheduling and conversion of cases – ∙ Back End Operations –
- Grievance Handling – ∙ Timely Payments to Authorised Vendors –
- Projects handled include – ∙ System interface Creation for tracking the Appointment
- System Interface for Payouts to Medical centers
Education
Bachelor of Commerce - Bachelor of Commerce
Mumbai University
Vivek School Of Commerce 2000.06 - 2021.08
Skills
Computer Proficiencyundefined
Timeline
AVP of Operations
HealthAssure Pvt Ltd
2013.08 - Current
Assistant Manager
Health India TPA Pvt Ltd
2011.03 - 2013.08
Executive
Birla Sun Life Insurance Company Limited
2006.12 - 2010.09
Executive
Bhaichand Amoluk Insurance Co. Pvt Ltd
2003.12 - 2006.02
Bachelor of Commerce - Bachelor of Commerce
Mumbai University
2000.06 - 2021.08
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