TM-Business Ops(Thane)

Aditya Birla Capital; Maharashtra; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

Aditya Birla Health Insurance Co. Limited (ABHICL) seeks a seasoned operations leader to oversee complex health insurance activities, ensuring efficient delivery and strict adherence to regulatory and internal guidelines.

The role emphasizes optimizing both human and technical resources to support planned business growth within Group Operations. The incumbent will drive process improvements, partner with internal teams and external vendors, and lead digitization initiatives to enhance service

Job description

` Annexure I : ABG Job` Description Template ` HayGroup Job Description Template 2011 Basic Details: Fill the required information about business, unit, location, position, reports to position and date of updation of JD` Business Health Insurance Unit Aditya Birla Health Insurance Company Ltd Location Thane, Mumbai Poornata Position Number of the job Reports to: Poornata Position Number Poornata Position Title of the job Manager / Sr.Manager Reports to: Poornata Position Title Associate Vice President Function Operations Reports to: Function Operations Department RUG Reports to: Department RUG / Group Operations Designation of the Employee Manager / Sr. Manager - RUG / Group Operations Designation of the Manager AVP / Sr. Chief Manager - RUG / Group Operations Date of writing/updation of JD` Annexure I : ABG Job` Description Template ` HayGroup Job Description Template 2011 1)`

Job Purpose

Write the purpose for which the job exists (in 2-3 lines)

The role will be responsible for efficiently leading operational activities of BFL / Hero Fincorp / Godrej -Group Operations and ensure that the same is delivered with adherence to all statutory, regulatory and internal guidelines. The role will be required to ensure optimum usage of technical and human resources to support the planned business growth in accordance with the agreed business strategy.

• Dimensions: Mention quantitative or qualitative parameters that are relevant for the job and provide a better understanding of the scope and scale of the job.

Dimension Remarks

• Manage Transactions : MPH Creation COI Issuance

Partner Servicing Cancellation and Refund Transaction settlements & Recon COI Communication BG / CD Statement & Recon Transaction sharing with TPA Project ( System Go Live ) Adherence to SLA : 100%

• Span of the role All digital partners such as BFL / Hero Fincorp / Godrej etc. Insurance Products coverage: Indemnity

Business Type; New Business and Renewal Active engagement with Partners & internal & external stakeholders.

• Systems BPM : HealthBuzz , Jarvis Partner Portals CRM
• Processing Parameters ? 100% adherence with Standard SLA ? Maintaining industry best TAT and Accuracy level. ? Optimum capacity utilization
• Issuance: T ? Endorsement: T ? CRM: T ? Cancellation & Refund: T+1 ? Cost reduction on Policy Printing & Dispatch
• Project Digitization / Automation
• Vendor Management Co-ordinate with all associate Partners / vendors and ensuring all business transactions are carried basis set SLA’s ? 100 % adherence with SLA
• Cost Effective Operations Periodic review of Operational cost including communication considering premium in nature
• Projects

Leading & Executing all projects and system developments (Mission Transformation)

Job Context & Major Challenges

About the Health Insurance Industry – While the current market sees more than 15 non-life players in the private space and 5 exclusive private players in the health insurance space trying to capture a sizable market share, the nationalized service provider (6) remains a strong competitor. In addition to this the business dynamics are such that the overall market on an annual basis which is to the tune of roughly 10,000 Crs sees close to 85 % of the business renewing with the existing service provider itself. This narrows down the opportunity of the fresh business actually being seriously fought in the market to approximately 1500 odd Crs. With the SME and the start-ups being the driving force of Indian economy, the opportunity to cater to these segments is immense and is increasing manifold year on year. The challenge here therefore remains as to how we capture a larger share of the opportunity by developing specific solutions to cater each segment of the business. Also by creating an inexpensive and standardised solution to increase the reach into the pockets of channel partners across the country to harness on their captive business and explore new opportunities with them. Market Opportunities – With the advent of medical advancements, lifestyle changes, change in Indian socio economic scenario and Indian healthcare space, and the insurers are facing challenges to cater to the needs of this diverse clientele. Increasingly Indian customers have started considering health insurance partners as extensions of health advisers. In this scenario it becomes extremely important to understand their psyche and then provide tailored solutions with wellness benefits which would help them meet their end objectives and bring in profitable revenue source for the company.

About The Aditya Birla Health Insurance –

Aditya Birla Health Insurance Co. Limited (ABHICL) was incorporated in 2015 as a 51:49 joint venture between Aditya Birla Capital Limited (ABCL) and MMI Strategic Investments (Pty) Ltd. ABHICL commenced its operations in October 20

• ABHICL has entered the competitive health insurance market with an aim to expand the category to wider customer segments, beyond the ones that health insurance companies traditionally have marketed to. As the 6th entrant in a category with well-established players, ABHICL is creating differentiation and equity for itself though the unique business proposition of “Health Insurance for All”, a one of a kind proposition in India at the moment. This is a philosophy that is being built through every single consumer touch point and into every single backend process of the company to ensure a customer’s experience of our proposition is continuous and seamless. ABHI’s unique offering to market includes proposition includes -
• A Comprehensive Incentivized Wellness Program that will attract the young and health conscious and will motivate, guide and reward them to stay healthy ? A Chronic Care Management Program to cater to the unmet needs of a growing Indian population of those suffering from chronic lifestyle conditions like Diabetes, Asthma, High Cholesterol and Hypertension from Day 1 ? ABHICL serves as an enabler and influencer of health and healthcare choices that customers make, in addition to being a payer of healthcare expenses. Thus, ABHICL would act like a much needed catalyst to grow the prevalent health insurance landscape in India through product innovations and a wider choice of consumer relevant products. ? ABHICL’s vision has always been digital. The company has been successful in adopting paper-less approach right from identifying to on-boarding to delivering seamless experience of its customers & employees.

Key Challenges ? Currently majority of business processes are manual and manpower dependent, hence urgent need of digitizing the operations, customer servicing and experience. ? Constant updation on process and procedures are required to provide the unified experience to customer and partners. ? Managing very large no of insured lives and corresponding transactions & recons with available Technology bandwidths. ? Inter departmental dependencies for customer resolution. ? Manage unplanned spike in the volumes with available manpower and technology bandwidths.

Key Result Areas

Supporting Actions Group Business Operations ? Ensure TAT’s & Accuracy targets of transactions while maintaining the regulator/company guidelines. ? Review process regularly and ensure that the changes are implemented.

• Liaise with distribution partners for periodic reviews and process alignment
• Ensure process and system reference manuals in place. ? Ensure publications and verification of all transaction reports on defined period. ? Co-ordinate and ensure that the system requirements are as per product and compliance guidelines ? Coordinating with the multiple stakeholders in the organization including Sales, Underwriters, IT, Legal, Finance to design a process as per the partner’s requirements ? Identify and ensure that the Customer satisfaction parameters are measured and monitored for improvement ? Work closely with distribution team and channel partners in designing new processes for business acquisition. 5)

Job Purpose of Direct Reports: Describe the job purpose of the direct report/s to the job (in 2-3 lines for each report)

Assistant Manager : Ensuring Policy Issuance and COI communication

Assistant Manager : Ensuring Transaction recon and settlement / Servicing

Relationships

Describe the nature and purpose of most important contacts or relationship (except superior/team members) with individuals, departments, organizations inside and outside of the organization, that job is required to interact with in order to deliver the job objectives

Relationship Type Frequency Nature

• Internal Finance Underwriting Claims Complaints and grievance Contact Centre Sales IT Compliance Marketing Regular MPH Setup Policy Issuance, Cancellation & Refunds New partner Onboarding
• Tech support Regulatory compliance Customer Communication External Distribution partner and vendors Service Vendors Regular Regular Ensuring active engagement with distribution partner and broker Ensuring service level management for outsourced activities

Organizational Relationships

Provide the structure for a level above and below the position for which this job description is written. Use position titles in the structured and indicate all the reports of the position.

SIGN-OFF: Provide the name of the Manager and the jobholder. Signature needed for the hard copy of the JD. Hard copy to be maintained in the organizational record.

Job Holder Reports to – Manager

Name

Signature (needed for the hard copy)

Head – RUG / Group Operations AVP – RUG / Group Operations Sr. Manager – Policy Issuance, Refund, COI recon Manager / Sr. Manager – Servicing / Transaction recon and Project