Dr Paresh Mhatre
Manama
Summary
- Proven track record of success in executive leadership roles within the TPA industry, with a focus on driving operational excellence, revenue growth, and profitability.
- A dynamic professional with over 21 years of experience in Health Insurance company and TPA
- In-depth knowledge of TPA regulations, compliance, and risk management, ensuring adherence to industry standards and best practices.
- Strong strategic planning and business development skills, with a demonstrated ability to identify market opportunities, develop innovative solutions, and forge strategic partnerships.
- Exceptional leadership abilities, adept at building and motivating high-performing teams, fostering a culture of collaboration, and achieving organizational objectives.
- Excellent communication and interpersonal skills, effectively engaging with stakeholders, clients, and industry professionals to cultivate relationships and drive business growth.
- Proactive and analytical approach to problem-solving, with a keen eye for identifying operational inefficiencies and implementing process improvements.
Overview
23
23
years of professional experience
Work History
General Manager
Health360 Ancillary Services WLL
09.2013 - Current
- Provide strategic direction and overall leadership to a leading TPA company, specializing in healthcare claims administration and benefit management.
- Develop and execute the company's vision, mission, and long-term growth strategies, aligning with market trends and client needs.
- Successfully led the organization through a period of significant growth, expanding the client base, and increasing annual revenue by 300%.
- Implemented operational improvements, leveraging technology and automation to streamline processes, enhance efficiency, and reduce costs.
- Strengthened relationships with key clients, ensuring high levels of client satisfaction and retention through exceptional service delivery.
- Cultivated strategic partnerships with healthcare providers, insurance carriers, and industry associations to drive business development opportunities.
- Directed a team of executives, managers, and staff, fostering a collaborative and performance-driven culture.
- Effectively supervise staff of 75 by implementing company policies, protocols, work rules and disciplinary action.
Assistant Manager
Bharain National Life Assurance Company
06.2010 - 09.2013
- Holds the credit of building standards in the claims department to ensure compliance with international standards in medical claim processing
- Administered a team of 25 members; deftly conducted weekly team meetings along with Supervisors & Team Leaders
- Extensively worked with helpdesk to ensure timely and decisive approvals
- Medical awareness presentations to policyholders as well as provider consultants
- Significantly involved in overseeing the provider pricing & grading as well as establishing and maintaining records on pricing
- Instrumental in controlling the medical cost along with service providers and giving presentation to the doctors
- Diligently reported on daily & weekly basis observations and non-performances with suggestions for improvement
- Carried out the maintenance of hospital price & package charges & negotiated on periodic basis
- Voluntarily visited to the hospitals and clinics for detecting fraud
- Steered efforts in reducing turnaround time in claims processing
- Accountable for reviewing claims audit processes & operations manuals with a view to improve process efficiency
- Undertook necessary corrective and preventive action to ensure that there was no deviation from the processes and guidelines laid were down in various operations manuals
- Efficiently & effectively appointed the employees as and when required as per budgets & ensured adequate & continuous training to staff
- Distinctively organised performance appraisal of employees down the line and arranged need based training
- Indigenously created and implemented an internal communication system
Claims Manager
Gulf Electronics Management Systems Co
02.2007 - 02.2009
- Deftly followed the workflow as per the documented process from claims settlement, policy maintenance and provider management
- Accountable for the auditing the policies of claims
- Distinctively established the fraud control system
- Instrumental in managing and ensuring compliance based on the scheduled standards
- Efficiently formulated the weekly & bordereau reports
Branch Manager
MDIndia Healthcare Management Ltd
01.2004 - 02.2007
Assistant Manager of Operations
Paramount Healthcare Management
04.2001 - 12.2003
Education
Medical Graduate - Medicine
Mumbai University
Mumbai01.2001
Advanced Diploma - Insurance And Risk Management
Chartered Insurance Institute
London01.2014
Fellowship - Insurance
Insurance Institute of India
Mumbai01.2005
Skills
- Empathic leader with innovative problem-solving skills and excellent team-building abilities
- Proficient in using independent decision-making skills and sound judgment to positively impact company success
- Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance
Core Qualifications
- Strategic planning
- Business operations
- People management
- Business management software
- Decision making
- Problem-solving
- Time management
Timeline
General Manager
Health360 Ancillary Services WLL
09.2013 - Current
Assistant Manager
Bharain National Life Assurance Company
06.2010 - 09.2013
Claims Manager
Gulf Electronics Management Systems Co
02.2007 - 02.2009
Branch Manager
MDIndia Healthcare Management Ltd
01.2004 - 02.2007
Assistant Manager of Operations
Paramount Healthcare Management
04.2001 - 12.2003
Medical Graduate - Medicine
Mumbai University
Advanced Diploma - Insurance And Risk Management
Chartered Insurance Institute
Fellowship - Insurance
Insurance Institute of India
Similar Profiles
Kathy WagnerKathy Wagner
Occupational Therapy Assistant at Stein Ancillary Services- Promenade health and Rehab.Occupational Therapy Assistant at Stein Ancillary Services- Promenade health and Rehab.
Robin NagyRobin Nagy
Business Development/Marketing - Office/Warehouse Manager at Columbia Ancillary ServicesBusiness Development/Marketing - Office/Warehouse Manager at Columbia Ancillary Services
Thalia Talamantes SalasarThalia Talamantes Salasar
Allergy Technician at Ancillary ServicesAllergy Technician at Ancillary Services