PRADNYA GAIKWAD
Mumbai
Summary
A multifaceted professional having 18 years of extensive experience in handling Business Operations, Profit & Loss Management, Project Management, Process Improvement, Client NPS & on-boarding with fervent experience in National Health Service, Clinical Health & Public Health Services in UK, USA and India.
Overview
9
9
years of professional experience
Work History
Senior Clinical Delivery Manager-Operations
Inventurus Knowledge Solutions
Mumbai
- Exceptional in ramping up of 50 providers in 4 months and played an important role for providing oversight over day to day operational activities to Senior Management
- Proficient in identifying risks, issues, considering best practice and current options and monitoring the progress of the project and reviewing current process for developing service mapping, stakeholder workshops and process mapping
- Demarcated abilities in managing account P&L client worth annual revenue of $6M+ and managed 450+ personnel strength teams across 3 strategic US healthcare clients
- Proven Excellence in handling operations & improved processes of 350+ FTEs, generating a revenue of US $6M+
- Proven excellence in directing and implementing six sigma projects to improve process from 82% to 98% and maintaining it consistently based on Kaizen and six sigma concepts
- Significantly improved quality of process by changing quality model from DPMO to DPU, introducing TQM and CTQ drill in the process thereby improving quality from 94% to 99.2%
- Successfully created PMR project and generated revenue of 130k $, delivered 12 projects and involved in new business creation of 4 projects and supported Solution team for transition activities.
Director - Operations
Inventurus Knowledge Solutions
Mumbai
08.2017
- Significantly managed teams of size 500+; including hiring, training, performance reviews and disciplinary action
- Prudent in managing accounts receivable for 2 major critical client totaling $3 M in charges each month, including credentialing, denial management, EVBV
- Expertise in initiating Governance dashboard; maintaining strong relationship with all clients and presented trends in Weekly cadence
- Outshined in decreased billing cycle turnaround by 40% by implementing automation into the process
- Extended contribution in the implementation of EPM; revamped training in order of succession of 98% FTY (first time throughput yield) of new hires
- Substantially developed and implemented management controls and quality assurance processes to ensure the accuracy and efficiency of claims submission, payments and postings
- Dynamically collaborated with the team by enhancing employee engagement, addressed performance results and provided coaching and mentoring
- Diligently ensuring to follow established guidelines, instructions, policies, and procedures towards guaranteed profitability achievements.
Co-founder and Managing Director
Hatkesh Multi- speciality Hospital
Mumbai
10.2016
- Overseeing the day-to-day operations of the hospital
- Developing and Implementing long- term strategic plans for the hospital
- Ensuring the patients receive quality care and meeting regulatory requirements
- Recruiting and managing physicians, nurses, caregivers and various non-medical personnel
- Profound experience in establishing analytical frameworks, conducted complex business analyses, external research, and led teams to deep industry and service line competencies to enhance high-end strategy engagements
- Highly strategic in building a new consulting model and designed operations, standards and best practices
- Adroitly liaised with administration and medical staff while developing and managing a budget to improve clinical services.
Senior Chief Manager - Health Ops Mgmt
Aditya Birla Health Insurance
Mumbai
- Current
- Revamped Customer' Wellness Journey, introduced Digital facial scans saving organizational cost > 3 crore annually
- Automated data warehouse thus improving process TAT from 62% to 98% in 7 months of time
- Negotiated and secured vendor contracts with key clients, saving organizational cost > 5 crore annually
- Spearheaded a sustainability Digital Fitness project, Activ fit and Active one product for ABHI thus generating revenue of 10 crores in Q4
- Created Real -time Dashboard inclusive of Ops metrics and geographical data sets thus helping Senior Leadership to take strategic decision
- Worked along with IT / Ops / Underwriting team to enhance the processes, thus improving efficiency by > 60%
- Initiated Balance Scorecard, Governance dashboard maneuvering strategic decisions thus improving 65% productivity
- Worked along with Under-writing and Disease Risk Management team and re-instated Operational data along with BIU team
- Managing and tracking P&L ensuring the executed medicals are aligned within the budget
- Worked along with digital, marketing, Comms, Contact Centre, enhanced customer engagement by >80% and business conversion by > 70%, thus reducing churn rate
- Improved C-SAT and NPS score from 40 to 78 in 8 months of time
- Working along with Agency, Sales, Business Operations, Bancas, Advisors, conducted training on Wellness products, developed retention strategies including upsell.
Program Manager
London Borough (Local Authorities)
United Kingdom
01.2015 - 01.2016
- Diligently played a vital role in procurement of public health programs budget circa £4.8m for 200,805 populations
- Successfully generated revenue of GBP 4.8m per annum through effective management of 74 hospitals & Primary care in London borough
- Worked on projects using SWOT, PESTLE and designed tools to address behavioural causes of disease
- Designed and Implemented In-house projects, thus saving cost £10m, improved efficiency by > 75%.
Product & Sales Director
Care-view Services
United Kingdom
01.2015 - 01.2016
- Effectively co-ordinated with the Sales department and procured Mental health services in Birmingham for 1.5 M population, generating revenue of GBP 85 M
- Key player for client relationship, oversight contracted services and responsible to design products and upsell- cross- sell with team.
Education
Business Management - undefined
Indian Institute of Management, Bangalore (IIM-B)
Master's in Public Health - undefined
University of Wolverhampton, United Kingdom
Bachelors of Homoeopathic Medicine and Surgery - undefined
Maharashtra University of Health Sciences, India
PMP Training - undefined
Certificate of Black Belt- Six Sigma - undefined
Mumbai
Skills
P&L Management
Operations Management
Project Management
Lean Process Creation
Process Improvement
Customer centricity
New Product Development
Budgeting & Cost Optimization
Soft Skills
Communicator
Innovator
Collaborator
Intuitive / Team player
Analytical / Thinker
Accomplishments
- Reduced average days in A/R from 80 to 60 in 3-month span.
- Increased net collections from 50% to 85% -
- Reduced Patient A/R from $5.37M to $3M in 1.5-month time span.
- Improved productivity and decreased backlog by 25% within 3 months' span.
- Decreased billing cycle lag from 6.8 to 1.25 in 2 months' spans
- Achieved clean claim rate from 82% to 95% in 3-month time
- NPS and C-SAT from 40 to 78 in 8 months time
- Record of saving organizational cost, improved efficiency and process efficacy.
Performancesummary
Performance oriented professional having dynamic experience in operations, client services and successfully handled end-to-end implementation of projects in UK, USA and India. Successfully led digital healthcare projects and generated Revenue of 6.8 million $ per annum through effective management. Affluent experience in US healthcare & managed Medical transcription, Coding, Data Managing and Revenue cycle management. Highly successful in reduction of service delivery time span by 40%, improved TAT, achieved SLA and high customer satisfaction. Certified Six Sigma Black Belt, directed and implemented six sigma projects to improve business by 70.5% and Accomplished 99.5% client delivery quality levels by introducing continuous quality improvement. Demonstrated experience in directly overseeing business needs, service delivery, deriving projections and using statistical process control tools to measure and control quality. Strategically generated product solutions and frameworks/templates/roadmaps for new product development process. Highly tactical in planning & controlling operations/ projects; skills in conceptualizing process initiatives to enhance efficiency; talent for proactively resolving problems, ramping-up project activities with on time deliverables and maximizing efficiency. Upscaled team knowledge and augmented productivity by effectively training, monitoring and directing employees in application of best practices and regulatory protocols. An effective communicator with excellent presentation, interpersonal, analytical, problem solving & leadership skills.
Awardsrecognition
- Received 'Healthcare Leadership Award' in IGA 2024
- Received 'Woman Inspirational Award' in Story Times 2023
- Received Rancho- Team Award (Q3) at ABHI for Wellness Team, 2023
- Key Speaker on 'Patient Advocacy' in Dubai Health Conference 2023
Timeline
Director - Operations
Inventurus Knowledge Solutions
08.2017
Co-founder and Managing Director
Hatkesh Multi- speciality Hospital
10.2016
Program Manager
London Borough (Local Authorities)
01.2015 - 01.2016
Product & Sales Director
Care-view Services
01.2015 - 01.2016
Senior Clinical Delivery Manager-Operations
Inventurus Knowledge Solutions
Senior Chief Manager - Health Ops Mgmt
Aditya Birla Health Insurance
- Current
Business Management - undefined
Indian Institute of Management, Bangalore (IIM-B)
Master's in Public Health - undefined
University of Wolverhampton, United Kingdom
Bachelors of Homoeopathic Medicine and Surgery - undefined
Maharashtra University of Health Sciences, India
PMP Training - undefined
Certificate of Black Belt- Six Sigma - undefined
Mumbai
Similar Profiles
Parth SawantParth Sawant
Revenue Cycle Representative at Inventurus Knowledge Solutions Private LimitedRevenue Cycle Representative at Inventurus Knowledge Solutions Private Limited
Joel Varghese KurianJoel Varghese Kurian
Revenue Cycle Representative at Inventurus Knowledge SolutionsRevenue Cycle Representative at Inventurus Knowledge Solutions
Samrudhi KulkarniSamrudhi Kulkarni
Quality Expert at Inventurus Knowledge SolutionsQuality Expert at Inventurus Knowledge Solutions