Job Description

• Lead and oversee the end-to-end case management and complaint handling process.
• Monitor complaint trends, service performance, and SLA/TAT achievement.
• Conduct root cause analysis and drive resolution of complex customer cases.
• Coordinate with internal and external stakeholders to ensure timely case resolution.
• Analyze complaint and claims data to identify improvement opportunities and recommend corrective actions.
• Lead, coach, and develop the Case Management team to deliver excellent customer service.

Qualifications

• Bachelor’s degree in Medicine, Nursing, Midwifery, Public Health, Pharmacy, or Apothecary.
• Minimum 5–7 years of experience in health insurance, claims, hospitals, TPA, or complaint handling.
• Strong understanding of complaint management, health claims, SLA/TAT monitoring, and root cause analysis.
• Good analytical, l...