Subject Matter Expert (SME) – Provider Management

7 - 12 years

30.0 - 45.0 Lacs P.A.

Mumbai, Pune

Posted:2 weeks ago| Platform: Naukri logo

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Skills Required

Subject Matter Expertisefunctional documentationhealth insurancegap analysishealthcare insuranceconfiguration planning

Work Mode

Work from Office

Job Type

Full Time

Job Description

Role : Subject Matter Expert (SME) Provider Management ( Healthcare Insurance)- InsuranceTech Location : Mumbai / Pune ( with International Project Travelling) Job Summary: Role Summary We are looking for a Provider Management SME with strong domain expertise and hands-on experience in configuring and implementing provider platforms for health insurers. This role supports requirement gathering, gap analysis, and configuration planning, working closely with product teams and senior SMEs. Key Responsibilities : Assist in requirement discovery sessions with hospitals, clinics, and payer stakeholders. Define and document provider onboarding workflows, credentialing processes, and tariff configuration. Support platform configuration and user story creation aligned with business needs. Provide input for provider contract management features and compliance needs. Collaborate with technical teams to validate data structures and interface specifications. Educational Qualification / Work Experience & Skills : PG / MBA / BE / B.Tech with 6+ years in health insurance or healthcare provider domain. Familiarity with provider contracting, credentialing, package/tariff management, and SLA compliance. Experience working with provider portals or network management systems. Understanding of regulatory considerations in APAC. Strong functional documentation skills and platform thinking.

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