Senior Operations & Wellness Programs Leader
Resume:
Mumbai
**************@*****.**.**
NEELESH B LATPATE
Hardworking professional with background in managing high-performing teams and overseeing operational workflows. Skilled in strategic planning, budget management, and stakeholder engagement to drive business objectives and ensure successful project delivery. Adept at fostering collaborative environments and implementing process improvements to enhance efficiency and productivity.
SUMMARY
AVP, 01/2024 - Current
Finhaat Insurance Brokers, Mumbai
CHIEF MANAGER, 01/2022 - 09/2024
Raheja Qbe General Insurance, Mumbai
EXPERIENCE
• Boosted variety in wellness service provisions.
• Fulfilled diverse wellness requests from clients.
• Assessed and verified the credibility of various wellness service providers. Conducted successful negotiations and finalized arrangements for wellness programs.
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• Streamlined coordination of yearly health assessments tailored to client needs. Analysed client progress through regular follow-ups, adjusting wellness strategies to optimise outcomes.
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Partnered with healthcare professionals to ensure a holistic approach to client health and wellbeing.
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Collaborated with corporate clients to develop workplace wellness programmes, reducing absenteeism and improving productivity.
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Conducted evaluations of wellness programmes, gathering feedback to improve offerings and increase participant satisfaction.
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Monitored and reported on the latest health trends and research, ensuring recommendations remained current and evidence-based.
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Delivered interactive workshops on nutrition, stress management, and physical activity to promote healthy lifestyles.
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Organised health fairs and wellness events, connecting participants with resources and information to support their health journey.
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Managed Claims and Investigation Dept with end to end management of Benefit and Indemnity Claims.
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• Developing and Adding triggers for system development.
• Vendor performance analysis through various Dashboards.
• Vendor Empanelment due diligence.
• IRDAI Level Meetings attended.
MANAGER, 03/2019 - 01/2022
Paramount TPA, Mumbai
ZONAL MANAGER, 01/2018 - 02/2019
Max Bupa Health Insurance, Mumbai
DEPUTY MANAGER, 05/2017 - 01/2018
Cholamandalam Murugappa, Mumbai
ASSISTANT MANAGER, 08/2016 - 04/2017
UnitedHealth Group (UHG), Mumbai
ASSISTANT MANAGER, 02/2013 - 08/2016
Medi Assist TPA, Mumbai
• Hospital Empanelment and managing Providers,
Resolving grievances with Provider, Cashless Claims Management with Audits, Case Negotiation, wellness, Discount finalization.y
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• Working in building system based triggers.
• Provider Management West Zone
• Hospital Empanelment
• Wellness Tie up
• Working on MOU with Top Hospitals
Special tie ups involved in POC {point of Care Setups with Hospitals} for Servicing as well as BD
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Hospital Empanelment, Provider Management, Negotiation, Relationship Management with provider, Grievances escalations management with provider, Increasing the provider strength with new tie ups
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• Conducting Audits as required
• Conducting wellness activities for the region
• Investigation Management and conducting investigation as when required
• Designing and managing the wellness initiatives for company client
• Performing Market research to identify emerging trends in Wellness portfolio Designing healthcare products under wellness to promote wellbeing in individuals
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Designing material for corporate communications to educate employees on disease management programs for lifestyle diseases like Cardiac Ailments, Hypertension, Diabetes etc
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• Creating documents and materials on health and wellness activities
• Working with the information and technology team to promote wellness Coordinating with the CRM team in different locations to execute and coordinate wellness programs
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Coordinating with BD Team for development of wellness program to get new Cliental
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Responsible for Hospital Empanelment, Provider management and provider relationship with finalization of tariff empaneling new providers, Reconciliation, handling providers grievances and escalations
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• Increasing the network-Strength
Conducting Hospital Infrastructure Audit and grading of Hospitals according to facilities
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• Hospital Empanelment, Provider Management, Negotiation, Relationship MEDICAL OFFICER MANAGER, 01/2010 - 01/2013
Micro-Insurance, Mumbai
MEDICAL OFFICER (INVESTIGATION), 01/2009 - 12/2009 Health India TPA, Mumbai
Management with provider, Grievances escalations management with provider, Increasing the provider strength with new tie ups
• Conducting Audits as when required
• Conducting wellness activities for the region
To ensure coordination during Cashless process for smooth cashless and resolve query if any between Cashless team and hospital
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Taking care of Networking activities which involved Hospital / Diagnostic Empanelment's, finalization of tariff with hospitals
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• Relationship Management with the providers
• Conducting wellness activities and OPD's
• Conducting investigation as when required
• Applying triggers and shortlisting suspicious cases
• Vendor Management and Onboarding new vendors
• Followup of cases through vendors
• Conducting high value investigations
SKILLS • Provider Negotiation
• Hospital Empanelment
• Discount Finalization
• Mou And Contract Finalization
Conducting And Managing Wellness
Events
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• Claims
• Audits
System Automation Claims
perspective
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System Development Investigation
perspective
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• Claim Analysis
• Tariff Negotiation
• Case Management
• Case Negotiation
• Assisting BD
• MS Office
• MS Office Word
• Power Point Presentation
• Excel
• VLOOKUP
• Pivot Table
• Word
• Powerpoint
CERTIFICATIONS Experience in Claims / Provider Management / Wellness Institute of Chartered Financial Analysts of India (ICFAI), Tripura, 01/2016 MBA/PGDM: Hospital Management
maharashtra university of health sciences, nashik, 01/2007 BHMS: Homeopathy
EDUCATION
LANGUAGES English: Hindi:
Marathi:
PERSONAL
INFORMATION
• Date of birth: 09/26/81
• Gender: Male
• Marital status: Married
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