Ravikumar Modali

P & L responsibility, Corporate tie ups, Business network expansion, Govt schemes
Service line development, utilization management.
Financial and Service outcomes management.

 Executing healthcare programs, healthcare analytics and interventions for quality improvement, risk reduction.
 Business integration and networking - Empanelment, performance reviews, claims intelligence.
 Risk Assessment, Screening programs, Lifestyle coach, Preventive Care, Disease Management and Pathway management
 Co-developed health measurement tool with internationally renowned entity that was also presented to Minister of Technology, India.
 Contributor to National initiative in Wellness, Health Management Services
 Mentoring inter-organizational clinical operations through integrated service design, talent management, decision algorithms, patient safety, infection control, risk management and clinical quality.
 Strategic Alliance development with international entities like Swiss Re and sharing business intelligence.

 Established navigation system for emergency care services raising utilisation level of emergency care services.
 Lead pre-hospital medical operations (about 25000 per month) through a team of Emergency Response Centre Physicians (ERCPs) and certified Emergency Medical Technicians (EMTs).
 Maintaining network of 3500 hospitals through geo-mapped network intelligence for establishing seamless emergency care continuum.
 Dynamic statistical modelling, syndromic surveillance for mission critical interventions planning.
 Propagating emergency care protocols, processes and standard operating practices through training programs, CMEs, peer group discussions.
 Cross-Industry collaborations with peer organizations, professional bodies, hospital teams and various government bodies for systemising end-to-end emergency care services.
 Planned and organised 7 CMEs and conferences in academic medical colleges in the field of Emergency Care.

 Managing healthcare operations including care processes and service delivery.
 Lead a medical team of 112 for handling nationwide preauthorization, claims adjudication, trends analysis, benchmark comparisons and negotiations with hospitals and management of hospital networks.
 Set up and managed all India network of service providers (7, 500) and optimising healthcare service to covered population.
 Healthcare analytics with Actuaries, Marketing Managers and Policy Administrators for working on health insurance products.
 Hospital & medical audits and improvement planning (ISO 9001:2000, Business Excellence, Insurance Companies and IRDA).
 Conceptualised disease programs (DM, Geriatric Care, Emergency Care) for corporate groups.
 Adopted data based information practices for hospitals, practices and insurers.
 Worked on the development of clinical protocols, information-based decisions and utilization management.