Kavya Srivastav

Experience

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  UnitedHealth Group

  Sept 2014 - Jul 2015

  Associate Investigator

  Prevented the payment of potentially fraudulent and/or abusive claims utilising medical expertise. Knowledge of CPT/ diagnosis codes, CMC guidelines along with referring to client specific guidelines and member policies

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  Aditya Birla Health Insurance Company Limited

  Feb 2017 - Feb 2020

  Assistant Manager

  Strategizing and implementation of provider and partner management process and developing opportunities PAN India Coordination with these providers and partners along with identification, selection of these partners, defining and monitoring the SLAs and ensuring end to end implementation of their services Management of vendors; Monitoring and evaluation of 12 TPAs and 8 healthcare partnersImplementation of Health Risk Management projects for providing better quality of healthcare to customers and cost control Development of SOPs and guidelines, detailing policies, processes and procedures, for creating new network hospitalsSuccessful implementation of First phase of Network Providers Quality Audit PAN India (130+ hospitals) Adherence to standard regulatory guidelines and accreditation bodies applicable to insurance companies hospitalsSetting up claim automation process to reduce claim settlement TAT from 30 days to 7 daysDevelopment and implementation of clinical rules for internal claims and financial auto adjudicationControlling the fraud, waste and abuse by keeping a close check on blacklisted hospitals and their claim processingConceptualization and automation of dashboards to provide objective insights with key actionable to improve productivityDrive adoption/usage of the development and dashboardsImplementation of various internal projects to improve the service qualitySupporting cross functional projects to enhance customer experience during hospitalization Introduction of new changes and enhancements in the existing provider management systemAnalysis of market, competition and conduct market research to identify opportunities, threats and key issuesDocumentation and report making for organizations like IRDA, Niti Aayog, NHA, TISS etc Team building and Provider training along with induction programsConducting training workshops on Hospital Quality Audit and EmpanelmentConceptualization and delivery of training sessions for field team Show less

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  Axis Bank

  Feb 2020 - Apr 2022

  Deputy Manager

  Process ImprovementRefining service delivery processes and where appropriate contributing to improved business outcomesResponsible for managing SMS Banking and Communications Hub project- central repository of all transactional communications to the customerDLT portal managementSuggesting cost saving opportunities and improvement ideas to current processesSupporting business to solve complex customer issues with respect to SMS delivery and proactively prevent negative service trends and process standardizationVendor ManagementManaging relationships with third party digital delivery partners, focusing on performance management against agreed SLAs and KPIsConducting periodic meetings with vendorsIdentifying areas of improvement and drive specific initiatives to address issues around SMS deliveryDocument ManagementPreparing SOPs and other documents (CMC/VMC/Audit) and ensuring adherence to applicable statutory and regulatory requirements, Axis Bank standards and policies. Constructing process flow diagrams to provide visual representation of activities and relationshipsProject ManagementCreating plan for every project and tracking milestones for closurePreparing business requirement documents (BRD) for all the required developmentsSupporting User Acceptance Testing strategies and execution plans and testing the completed development in line with BRDReportingMaintaining Continuous Improvement and Quality reporting and analysis - monthly, quarterly, ad-hocCreating MIS, dashboards and providing analytical insights on performance standards on a periodic basisAudit FacilitationInternal auditing and check round program- responsible for participating as a facilitator in internal auditing program and follow-up of actionsAdhering to compliance and regulatory requirements.Change Control ManagementResponsible for approval, verification and closure of change controls as per process Show less

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  Deutsche Bank

  Mar 2022 - now

  • Assistant Vice President

    Mar 2025 - now

  • Associate

    Mar 2022 - Mar 2025