Zonal Hospital Network Manager - North & East

The role is with a leading General Insurance company.

Job title - Zonal Hospital Network Manager

Reporting to Head of Claims and Network Management

Location - Delhi (North & East Zone)

Coverage: North & East India including Delhi NCR, North India states, East India, and North-East region.

Role Overview

This is a senior leadership role responsible for building, expanding, and managing the hospital network across the North & East zones. The role will drive hospital empanelment, tariff negotiations, SLA management, and network performance to ensure high-quality, cost-effective, and seamless healthcare delivery for customers.

Key Responsibilities:

Network Strategy & Development

• Define and execute hospital empanelment strategy across key business locations.
• Lead provider contracting, tariff negotiations, and strategic purchasing of healthcare services.
• Build strong, long-term relationships with hospital leadership and key decision-makers.

Operational Leadership

• Lead and mentor zonal network teams across negotiations, audits, and performance management.
• Drive digital onboarding, credentialing, and contract renewal processes to improve efficiency.
• Work closely with claims, sales, operations, and customer service teams for smooth service delivery.

Cost & Quality Management

• Optimize tariffs using market intelligence and utilization data.
• Implement cost control, leakage prevention, and fraud management measures.
• Ensure quality standards, NABH compliance, and patient safety across network hospitals.

Performance & Analytics

• Define and track KPIs such as utilization, TATs, patient experience, and hospital performance.
• Use data analytics to derive insights and improve network effectiveness.
• Prepare regulatory and management reports, including IRDAI submissions.

Market Intelligence & Digital Enablement

• Track healthcare market trends, regulatory changes, and competitive benchmarks.
• Champion digital health initiatives including hospital relationship platforms, ABDM, and NHCX integration.

Candidate Profile:

Experience & Education:

• 810+ years of experience in healthcare or insurance, with at least 5 years in senior network leadership roles.
• Strong experience managing large hospital networks in insurance companies, TPAs, or hospital chains.
• Postgraduate degree preferred (MBA Healthcare / Hospital Administration / Marketing).
• Clinical qualification with management education is an added advantage.

Key Skills:

• Strong leadership and people management capability.
• Excellent negotiation and contract management skills.
• Data-driven and analytical mindset.
• Strong stakeholder communication and influence.
• Deep understanding of the Indian healthcare and regulatory ecosystem.