Seema Pise
Mumbai
Summary
Regional Manager with a proven track record at Navi General Insurance, specializing in strategic planning, stakeholder management, and operational efficiency. Expertise in contract negotiation, achieving significant cost reductions while enhancing service quality and compliance. Skilled in team leadership and relationship building, driving continuous improvements in the healthcare sector.
Overview
10
10
years of professional experience
Work History
Regional Manager - Strategy and Business Operations - Provider Partnerships Team
Navi General Insurance Pvt Ltd
02.2022 - Current
- Lead, mentor, and develop a high-performing team, ensuring operational excellence.
- Identify, empanel, and manage service providers across the West Zone.
- Conduct audits to evaluate service quality and compliance.
- Oversee contract negotiations, agreements, and documentation management.
- Build and maintain strong relationships with stakeholders and service partners.
- Optimize claims handling through risk analysis, fraud detection, and efficiency improvements.
- Ensure regulatory compliance, financial risk mitigation, and seamless operations.
- Continuously review service providers, claims, and investigations to drive improvements.
Deputy Manager
Aditya Birla Health Insurance Private Limited
04.2019 - 01.2022
- Led strategic empanelment of top-tier healthcare providers, ensuring high-quality medical services.
- Implemented cost-control measures, optimizing Average Claim Size (ACS) and driving profitability.
- Negotiated and restructured contracts, strengthening partnerships and reducing claim costs.
- Developed targeted strategies for Covid case management, effectively minimizing ACS for pandemic-related claims.
- Expertly handled provider grievances, fostering strong relationships and ensuring seamless operations.Spearheaded strategic empanelment of top-quality healthcare providers, ensuring exceptional medical services
- Implemented innovative measures to control Average Claim Size (ACS), resulting in cost savings and improved profitability
- Successfully renegotiated contracts, fostering stronger partnerships and reducing average claim size
- Played a key role in managing Covid cases, implementing strategies to minimize ACS for Covid-related claims
- Demonstrated exceptional skills in handling provider grievances, maintaining harmonious relationships for efficient operations
Medical Officer - Provider Partnerships
Medi Assist Insurance TPA Ltd
11.2017 - 04.2019
- Onboarded top service providers, reducing insurance claim ratios
- Negotiated favourable rates, discounts, and packages with providers
- Resolved hospital problems, fostering positive relationships and smooth operations
- Enlisted best hospitals for cashless OPD services in the Infinity
Nutritionist
Jaslok Hospital
01.2017 - 11.2017
- Managed floor operations and departmental administration for smooth functioning
- Conducted regular ward rounds, providing diet counselling and wellness advice
- Created personalized diet charts based on anthropometric data
- Provided nutrition consultations to patients in the outpatient department
- Ensured efficient inventory management for day-to-day operations
Nutritionist
Lifespan Pvt. Ltd
02.2016 - 07.2016
- Provided individualized diet and lifestyle counselling, empowering clients to make informed choices
- Maintained accurate and up-to-date records and reports for effective management
- Managed daily clinic operations, including administration and inventory management
- Coordinated with consultants for smooth functioning of the clinic
Nutritionist
Bhatia Hospital
06.2015 - 07.2015
- Conducted regular ward rounds, counselling patients on diet and wellness
- Developed personalized diet charts based on patient's anthropometric data
- Ensured patients received appropriate meals according to their diet plans
- Designed plans for enteral tube feeding & Maintain accurate records
Education
Executive Programme - Healthcare Management
Indian Institute of Management-Calcutta
01.2022
Master of Business Administration - Health Care Management
Welingkar Institute of Management
01.2018
PGD - Nutrition & Dietetic
SNDT Women's University
01.2018
T.Y.B.Sc. - Biochemistry with Nurtition
University of Mumbai
01.2013
Skills
- Strategic Planning & Vision
- Decision-Making & Problem-Solving
- Negotiation & Influence
- Team Leadership & Development
- Stakeholder & Relationship Management
- Operational Excellence & Efficiency
- Communication & Interpersonal Skills
- Change Management & Adaptability
- Analytical Thinking & Risk Management
- Emotional Intelligence & People Management
Accomplishments
- 03/23, Awarded with certificate for going the extra mile in delivering on a key cross-team initiative resulting in significant business impact.
- 01/22, Promoted to Cluster Manager from Associate.
- 2021-2022, Awarded with Rancho of the Quarter Award in Aditya Birla Health Insurance Private Limited.
Linguistic Skills
- English
- Hindi
- Marathi
Timeline
Regional Manager - Strategy and Business Operations - Provider Partnerships Team
Navi General Insurance Pvt Ltd
02.2022 - Current
Deputy Manager
Aditya Birla Health Insurance Private Limited
04.2019 - 01.2022
Medical Officer - Provider Partnerships
Medi Assist Insurance TPA Ltd
11.2017 - 04.2019
Nutritionist
Jaslok Hospital
01.2017 - 11.2017
Nutritionist
Lifespan Pvt. Ltd
02.2016 - 07.2016
Nutritionist
Bhatia Hospital
06.2015 - 07.2015
Executive Programme - Healthcare Management
Indian Institute of Management-Calcutta
Master of Business Administration - Health Care Management
Welingkar Institute of Management
PGD - Nutrition & Dietetic
SNDT Women's University
T.Y.B.Sc. - Biochemistry with Nurtition
University of Mumbai
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