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Rajiv Gandhi Jeevandayee Aarogya Yojana Society Government of Maharashtra

Aarogya Bhavan Fourth Floor, St. Georges’ Hospital campus,

Near CST station, Mumbai 400001, Maharashtra

Request For Proposal for

Empanelment of Manpower Agency for

Rajiv Gandhi Jeevandayee Aarogya Yojana Project

Website: www.jeevandayee.gov.in

Email: [email protected]

Phone: 022-22626755

http://jeevandayee.org/

RFP for the Empanelment of Manpower Agency for RGJAY Project

Rajiv Gandhi Jeevandayee Aarogya Yojana, Government of Maharashtra Signature and Stamp of Tenderer Page | 2

Tables of Contents

1. Invitation for Proposal ........................................................................................................... 6

2. RFP Schedule - Important Dates ............................................................................................. 7

3. Instruction to the Applicants .................................................................................................. 8

3.1. Terms Used ................................................................................................................... 8

3.2. Submission of Proposal .................................................................................................. 8

3.3. Method of Submission of Proposals ................................................................................ 8

3.4. Late Submission ............................................................................................................. 9

3.5. Cost of Bidding .............................................................................................................. 9

3.6. Opening of proposal....................................................................................................... 9

3.7. Earnest Money Deposit .................................................................................................. 9

3.8. Erasures or Alternations and Signing of Proposal Offers ................................................. 10

3.9. Costs and Currency ...................................................................................................... 10

3.10. Fixed Price ............................................................................................................... 10

3.11. Offer Validity Period ................................................................................................. 10

3.12. Right to Alter Items .................................................................................................. 10

3.13. Modification and Withdrawal of Offers...................................................................... 10

3.14. Preliminary Scrutiny ................................................................................................. 10

3.15. Clarification of Offers................................................................................................ 11

3.16. Amendment of bidding Document ............................................................................ 11

3.17. Language of Proposal ............................................................................................... 11

3.18. Confidentiality.......................................................................................................... 12

4. Introduction to Rajiv Gandhi Jeevandayee Aarogya Yojana .................................................... 13

5. Project Scope of Work ......................................................................................................... 15

5.1. Category and Grades of the resources........................................................................... 16

5.2. Head Office ................................................................................................................. 16

5.2.1. Call Center ........................................................................................................... 17

5.2.2. Grievance............................................................................................................. 18

5.2.3. Training and Capacity Building............................................................................... 19

5.2.4. Empanelment....................................................................................................... 20

5.2.5. Health Camps ....................................................................................................... 22



5.2.6. Audit.................................................................................................................... 23

5.2.7. IT & MIS ............................................................................................................... 24

5.2.8. IEC Publicity ......................................................................................................... 25

5.2.9. Back Office support .............................................................................................. 25

5.3. Regional Office ............................................................................................................ 26

5.4. District Office .............................................................................................................. 28

5.5. Aarogyamithras/Hospital Support Staff ......................................................................... 30

5.6. Field Level staff............................................................................................................ 31

5.7. Indicative salary benefits .............................................................................................. 31

6. Payment Schedule ............................................................................................................... 34

7. Service Level Agreement...................................................................................................... 35

7.1. Service Level Objectives ............................................................................................... 35

7.2. SLA definition, Measurement and Monitoring ............................................................... 35

7.3. Force Majeure ............................................................................................................. 37

8. Qualification Criteria and Proposal Evaluation....................................................................... 39

8.1. Prequalification Criteria................................................................................................ 39

8.2. Evaluation and Selection Criteria .................................................................................. 39

8.3. Structure of the Proposal Response .............................................................................. 40

8.4. Contract Negotiations .................................................................................................. 41

8.5. Notification of Award ................................................................................................... 41

8.6. Deciding Award of Contract .......................................................................................... 41

9. Terms and Conditions Governing the Contract ...................................................................... 42

9.1. Signing of Contract....................................................................................................... 42

9.2. Performance Bank Guarantee (PBG) ............................................................................. 42

9.3. Validity Period of the contract ...................................................................................... 43

9.4. Responsibilities of Applicant ......................................................................................... 43

9.5. Resolution of Dispute ................................................................................................... 43

9.6. Arbitration................................................................................................................... 43

9.7. Conflict of Interest ....................................................................................................... 43

9.8. Governing Language .................................................................................................... 43

9.9. Applicable Laws ........................................................................................................... 43

9.10. Indemnification ........................................................................................................ 43

10. Annexures ....................................................................................................................... 45



10.1. Annexure A: Company Profile.................................................................................... 45

10.2. Annexure B1: Technical qualification proposal checklist.............................................. 46

10.3. Annexure B2: Compliance Certificate Format ............................................................. 48

10.4. Annexure B3: Technical Evaluation Criteria ................................................................ 49

10.5. Annexure C: Clarification seeking format ................................................................... 49

10.6. Annexure D: Format for Commercial Proposal........................................................... 50

10.7. Annexure E - Proposal Covering Letter ....................................................................... 51

10.8. Annexure F - Performance Bank Guarantee Form (PBG).............................................. 52

10.9. Annexure G - Self Declaration Form for not having pending cases in court of law ......... 53

10.10. Annexure H - Notarized Affidavit ............................................................................... 53

10.11. Annexure I - Draft Contract Form (CF)........................................................................ 54

10.12. Annexure J - Format for Bank Guarantee for EMD ..................................................... 56

10.13. Annexure K - Details of Regions in Maharashtra ........................................................ 57

10.14. Annexure J - Department wise Work Profile and Skills Requirement ............................ 58

10.15. Annexure K - Organogram......................................................................................... 62



Important Clarifications

Following terms are used in the document interchangeably to mean:

'RFP’ means this Request for Proposal document

‘Proposal’ may be interchangeably referred to as ‘Offer’

‘RGJAYS’ means Rajiv Gandhi Jeevandayee Aarogya Yojana Society

GoM means Government of Maharashtra

‘PBG’ refers to Performance Bank Guarantee

The term ‘Applicant’, ‘Selected Applicant’ and ‘Successful Applicant’ are used

interchangeably throughout the RFP document



1. Invitation for Proposal

‘The Rajiv Gandhi Jeevandayee Aarogya Yojana Society’ (hereinafter referred to as the

“RGJAYS”) invites the proposal for empanelment of the Manpower Agency (MPA) to provide

and manage the staffing requirements for implementation of the Rajiv Gandhi Jeevandayee

Aarogya Yojana (RGJAY) across the State of Maharashtra.

The proposal document can be purchased by the interested applicants (by providing an

application on the letter head that the person is authorized to collect the document) from

the office of the Rajiv Gandhi Jeevandayee Aarogya Yojana Society, 4th Floor "AAROGYA

BHAVAN, St. Georges Hospital Compound, Mumbai - 400 001 on payment of non-refundable

proposal document fee Rs.2000/- by demand draft from 17th November 2012 to 6th

December 2012 during office hours (10.00am to 17:00 pm) or the same can be downloaded

from website www.jeevandayee.gov.in.

The details are given below –

Proposal Reference No. Rajeev Gandhi Jeevandayee Aarogya Yojana/RFP-UOP 6/2012-13

Proposal fee(Non

Refundable)

Rs. 2,000 (Rupees Two Thousand Only)

This will be in the form of Demand Draft (DD) of a nationalized bank drawn in favour of “Rajiv Gandhi Jeevandayee Aarogya

Yojana Society, Mumbai” payable at Mumbai. Earnest Money Deposit cccc(EMD) (Refundable)

Rs. 5,00,000(Rupees Five lakhs Only) This will be in the form of a Demand Draft of a nationalized bank in favor of “Rajiv Gandhi Jeevandayee Aarogya Yojana

Society, Mumbai” payable at Mumbai to be submitted along with the Proposal Covering Letter (Annexure –E).

Address for Communication Office of the Rajiv Gandhi Jeevandayee Aarogya Yojana Society 4th Floor, Aarogya Bhavan, St. Georges Hospital Compound, Mumbai - 400 001 Phone No.: 022-22626755 E-mail: [email protected]

Telephone Number Phone No.: 022-22626755

http://jeevandayee.org/

mailto:[email protected]



2. RFP Schedule - Important Dates

Event Target Date

Start date of sale / availability of RFP

document (in person and through

download)

17th November 2012 to 6th December

2012(10:00 hrs. to 17:00 hrs.)

Last date and time to send in requests for

clarifications on the RFP 22nd November 2012

Pre- Proposal Conference 1500 hours 23rd November 2012

Last date for purchasing the RFP

document 6th December 2012

Last date and time for submission of

proposals (both technical proposal) 1400 hours on 7th December 2012

Opening of Technical Proposal 1500 hours on 7th December 2012

Address for submission of proposal

response

Office of the Rajiv Gandhi Jeevandayee

Aarogya Yojana Society, 4th Floor, Aarogya

Bhavan

St. Georges Hospital Compound, Mumbai

400 001

Phone No.: 022-22626755

E-mail: [email protected]

Presentation by the applicants To be intimated in due course of time

Declaration of Award of Contract To be intimated in due course of time

Applicants are required to note carefully, the requirements for submitting the proposals as

set-forth in this proposal document, and the date and time for submission of Proposals

(Technical). Late proposals and proposals without the required EMD and Proposal Fee shall

not be considered for evaluation and shall either not be received or returned unopened.



3. Instruction to the Applicants

3.1. Terms Used

“Eligible Applicant” means applicant satisfying technical qualifying criteria.

The term “Purchaser" means Chief Executive Officer, Rajiv Gandhi Jeevandayee Aarogya

Yojana, Mumbai.

“The Vendor” means the successful applicant or the dealer of the successful applicant with

whom the Purchaser enters into Contract against this RFP.

"The term Contract" means an agreement entered into by the Purchaser with the successful

applicant by signing a contract form in a given format by the parties, including all the

attachments and appendices thereto, and all documents incorporated by reference therein;

"The Contract Price" means the price payable to the Vendor under the contract for the full

and proper Performance of its contractual obligations;

"Services" means services to be provided as per the requirement mentioned in the scope of

work;

“Noncompliance” means failure/refusal to comply the terms and conditions of the

proposal;

“Non responsive” means failure to furnish complete information in a given format and

manner required as per the proposal documents or non-submission of proposal offer in

given Forms / Pro forma or not following the procedure mentioned in this RFP/ required

details or documents are missing/ not clear/not submitted in the prescribed format or non

submission of proposal fee or EMD.

3.2. Submission of Proposal Sealed Proposal offers shall be received before the time and date specified in the schedule

in this RFP. In the event of the specified date for the submission of proposal offers being

declared a holiday, the offers will be received up to the appointed time on the next working

day. The RGJAYS may, at its discretion, extend this deadline for submission of offers by

issuing corrigendum and uploading the same on the website. Telex, cable or facsimile offers

will be rejected.

3.3. Method of Submission of Proposals Technical Offers should be submitted by the applicants only and proposals should be

submitted on or before last date of submission.



3.4. Late Submission The proposals submitted late shall not be considered or returned unopened or liable to be

rejected by the department as per its discretion. Late proposal on any account shall be

rejected summarily. Delay due to Post or any other reason will not be condoned.

3.5. Cost of Bidding The Applicant shall bear all costs (whether in terms of time or material or money) associated

with the preparation and submission of its proposal including but not limited to attending

meetings, discussions, demonstrations etc. and providing any additional information

required by the department, and the purchaser will in no case be responsible or liable for

these costs, regardless of the conduct or outcome of the proposal process.

3.6. Opening of proposal On the date and time specified in the proposal notice following procedure will be adopted

for opening of proposal for which agency is free to attend himself or depute an authorized

officer as his representative.

Opening of Technical proposal -Technical proposal of the agency will be opened in the

presence of proposal opening authority and in the presence of agency / their

representatives

3.7. Earnest Money Deposit

The applicant needs to submit the Earnest money deposit (EMD) for Rs. 5,00,000 (Rupees

five Lakhs Only) along with the proposal form. EMD must be submitted in the form of a

demand draft or bank guarantee from any nationalized or scheduled bank in the form

provided in the proposal document (Annexure J) and valid for 60 days beyond the validity of

the proposal in favor of ‘Rajeev Gandhi Jeevandayee Aarogya Yojana Society, Mumbai ’.

Offers without Earnest Money Deposit will be rejected. Agency shall not be entitled for any

interest on EMD.

EMD will be returned to the successful applicants only after it submits a Performance Bank

Guarantee (PBG) as per the format given in Annexure F which will be 10% of the value of

contract expected through this RFP at the time of signing the contract. Unsuccessful

agency's EMD will be discharged / returned within 60 days after the expiration of the period

of proposal offer validity prescribed by the purchaser.

The EMD / Proposal Security may be forfeited if the applicant fails:

To execute the agreement / contract within given period of time from the date of

the issue of the Letter of the Intent.

To submit PBG as specified in the terms and conditions.



3.8. Erasures or Alternations and Signing of Proposal Offers The original Proposal Offer shall be signed by the Applicant or a person or persons duly

authorized to the sign such documents. Such authorization shall be indicated by power-of-

attorney accompanying the proposal offer. The person or persons signing the proposal offer

shall initial all pages of the proposal offer (technical proposal response), except for any un-

amended printed literature.

The Proposal Offer shall contain no interlineations, erasures or overwriting except as

necessary to correct errors made by the Applicant, in that case such corrections shall be

initialed by the person or persons signing the offer.

3.9. Costs and Currency The price will remain fixed for the period of the contract and no changes for any reason

what so ever will be allowed. The applicant shall bear all the costs associated with the

preparation and submission of its proposal, and the purchaser will in no case be responsible

or liable for these costs, regardless of conduct or outcome of bidding process.

3.10. Fixed Price The Commercial Offer shall be on a fixed price basis exclusive of all taxes like service tax,

etc. All the taxes and levies will be paid on as per actual basis.

3.11. Offer Validity Period

The proposal offer must be valid maximum for 24 months from the date of opening of the

proposal.

3.12. Right to Alter Items The Purchaser reserves the right to include or exclude any proposal item/s and to make

change in specifications of any items, in this case the number of resources or jobs. The

selected applicant will have to comply with the alterations done.

3.13. Modification and Withdrawal of Offers The Applicant may modify its proposal by way of submitting supplement with a request to

specific amendment in the original proposal submitted, provided a written request for the

same is received by the Purchaser before closing of the submission of proposal. However,

withdrawal of original offer will not be allowed. No offer can be modified by the Applicant,

subsequent to the closing date and time for submission of offers. If date of submission is

extended due to some reasons, modification in offer is possible till extended period

provided proposal has not been opened.

3.14. Preliminary Scrutiny Prior to the detailed evaluation, the Purchaser will determine the substantial responsiveness

of each offer to the proposal documents. For the purpose of this Clause, a substantially

responsive proposal is one, which is in conformity with all the terms and conditions of the



Proposal Documents without any material deviations. The purchaser’s determination of an

offer’s responsiveness will be based on the contents of the proposal offer itself without

recourse to extrinsic evidence.

RGJAYS, GoM will scrutinize the offers in respect of their completeness, submission of

technical documents duly signed, etc. The Purchaser will short-list technically qualified

applicants based on compliance of the pre-qualification criteria mentioned in Annexure B1.

The RGJAYS, GoM reserves the right to waive any minor infirmity or irregularity in the

proposal offer on recommendation of the committee, if he finds, it is in the interest of the

Government. The decision in these regards of RGJAYS, GoM will be final and binding on all

Applicants.

3.15. Clarification of Offers

To assist in the scrutiny, evaluation and comparison of offers, the Purchaser may, at

its discretion, ask some or all the Applicants for clarification of their offers on any of

the points mentioned therein and the same may be sent through email, facsimile.

However, in such cases, original copy of the technical clarifications shall be sent to

the Purchaser through courier or in person. The request for such clarifications and

the response shall be in writing.

3.16. Amendment of bidding Document

At any time prior to the deadline for submission of proposals, the purchaser may, for

any reason, whether on its own initiative or in response to the request for

clarification by a prospective applicant, modify the bidding documents.

All prospective applicants who have attended the pre-proposal conference

/purchased the bidding documents will be notified of the amendment in writing.

In order to allow prospective applicants reasonable time to take into the

consideration the amendments while preparing their proposals, the purchaser at its

discretion may extend the deadline for the submission of proposals.

Any addendum/corrigendum as well as clarification thus issued shall be a part of the

Proposal documents and it will be assumed that the information contained in the

amendment will have been taken into account by the Agency in its proposal.

3.17. Language of Proposal The proposal, as well as all correspondence and documents relating to the proposal

exchanged by the applicant and the purchaser, shall be in English language only. Supporting

documents and printed literature furnished by the applicant may be in another language

provided they are accompanied by an appropriate translation in English language and in

such a case, for purpose of interpretation of the proposal, the translation shall govern.



3.18. Confidentiality a. As used herein, the term “Confidential Information” means any information,

including information created by or for the other party, whether written or oral,

which relates to internal controls, computer or data processing programs,

algorithms, electronic data processing applications, routines, subroutines,

techniques or systems, or information concerning the business or financial affairs

and methods of operation or proposed methods of operation, accounts,

transactions, proposed transactions or security procedures of either party or any of

its affiliates, or any client of either party, except such information which is in the

public domain at the time of its disclosure or thereafter enters the public domain

other than as a result of a breach of duty on the part of the party receiving such

information. It is the express intent of the parties that all the business process and

methods used by the Applicant in rendering the services hereunder are the

Confidential Information of the Applicant.

b. The Applicant shall keep confidential any information related to this proposal with

the same degree of care as it would treat its own confidential information. The

Applicants shall note that the confidential information will be used only for the

purposes of this proposal and shall not be disclosed to any third party for any reason

whatsoever.

c. At all times during the performance of the Services, the Applicant shall abide by all

applicable security rules, policies, standards, guidelines and procedures. The

Applicant should note that before any of its employees or assignees is given access

to the Confidential Information, each such employee and assignees shall agree to be

bound by the term of this proposal and such rules, policies, standards, guidelines and

procedures by its employees or agents.

d. The Applicant should not disclose to any other party and keep confidential the terms

and conditions of this Contract agreement, any amendment hereof, and any

Attachment or Annexure hereof.

e. The obligations of confidentiality under this section shall survive rejection of the

contract.

f. Any effort by the agency to influence the Purchaser in the Purchaser's proposal

evaluation, proposal comparison, or contract award decisions may result in the

rejection of the Agency's proposal.



4. Introduction to Rajiv Gandhi Jeevandayee Aarogya Yojana

The prime objective of the ‘Rajiv Gandhi Jeevandayee Aarogya Yojana’ scheme is to

‘improve access of Below Poverty Line (BPL) and Above Poverty Line (APL) families

(excluding White Card Holders as defined by Civil Supplies Department) to quality medical

care for identified specialty services requiring hospitalization for surgeries and therapies or

consultations through an identified network of health care providers’.

The phase I of the scheme is already live in 8 districts – Amravati,, Dhule, Nanded, Mumbai

and Mumbai Suburbs, Gadchiroli, Raigad and Solapur - from 2nd July 2012, covering around

49 lakhs beneficiary families. The RGJAY– Phase-I covers 30 specialized service categories

having 972 procedures and 121 follow up procedures. The scheme will be further extended

to other districts to cover the entire State of Maharashtra.

Implementation Framework of the Scheme

The Rajiv Gandhi Jeevandayee Aarogya Yojana is implemented through a g roup of hospitals

which may be government hospitals, private hospitals, day care centers, dialysis centers,

etc. who gets empanelled with the scheme for providing the scheme benefits to the

beneficiaries. The hospitals are selected through a systematic process of empanelment

conducted by Society and the third party administrator.

The beneficiaries of the scheme are citizens holding the Yellow/ orange ration cards with

annual income of Rs. 100000 or below. The Society issues a health card to the beneficiaries

based on the Food & civil supply department’s data. It is envisaged that the scheme will

provide cashless treatment to any enrolled beneficiary in any empanelled hospital.

For facilitating the treatment of the beneficiaries in the hospitals, each empanelled hospitals

will have more than one Aarogyamithra on a 24 x 7 basis who will enroll the beneficiaries,

guide the beneficiaries for diagnosis to the doctor, ensure that the patient gets treatment

and surgery as per scheme, ensure that the patient gets the post-operative treatments, etc.

The implementation framework of the scheme is illustrated in the following diagram:





5. Project Scope of Work

The RGJAY society is planning to empanel more than one manpower agencies to provide

staffing requirements for the project. The manpower agency has to manage the field

operations of the scheme including the head office/project office, regional office, district

office and field office. Empanelled Manpower agencies need to assist RGJAYS to form the

strategy for manpower management. Empanelled manpower agencies formalize the

reporting structure, reporting formats, standards Human resource related metrics e.g.

Education Qualification matrix (EQ matrix), KPIs and KRAs, performance based incentive

structure etc. as per instructions from the Society.

The resources selected shall be borne on the rolls of Manpower Agency (MPA). All activities

relating to payroll management and all statutory/compliance requirements such as P.F. and

E.S.I., relating to deployment of the resources shall remain the responsibility of MPA only.

MPA shall maintain and update relevant documentation / records for all resources. The

MPA will act as a pure agent of RGJAY Society for handling all Human Resources (HR) related

issues.

In all cases, MPA shall share authentic details of credentials of all shortlisted and selected

candidates including their curriculum vitea and bio data. The manpower selection and

deployment (including advertisement, short-listing of candidates, written tests, if any,

schedule of interviews, selection of resources) shall be completed as per timelines decided

by the Society. The MPA shall also maintain ten percent of the contracted strength ‘on

panel’ to meet the replacement/substitution and additional resource requirements within

the time period specified in Service Level Agreement.

Society reserves the right to interview the personnel either on its own or through an

appointed representative before their deployment. The MPA has to provide minimum of

three resources as options to the Society for interview against each profile. Society reserves

the right to reject all the three options provided by the MPA, if found unsuitable for the

profile. The numbers of resources mentioned in the subsequent sections are indicative and

may vary as per the requirement of society; selected MPA agrees to provide the manpower

timely in order to run the scheme smoothly. Society reserves the right to demand as many

number of resources, above or below the indicative requirement mentioned under

annexure D, on need basis and the Manpower agency shall be bound to provide them as per

the service levels. Society also reserves the right to hire resources outside the Manpower

agencies empanelled.

Society also reserves the right to reject any or all the resources supplied, even after

deployment, if they do not conform to the required qualifications or performance

specifications (i.e. if their performance is not satisfactory) or where the resource is absent

for 3 consecutive working days without any reasonable cause. The decision of the Society



shall be final and binding in the matter. Society also reserves the right to instruct the MPA to

terminate the services in respect of any or all the resources deployed, by giving a notice

period, in which case, a substitute shall be provided by the applicant as per SLA.

The applicant shall comply with the timelines as per SLA in respect of any substitution of

resources. For substitutions as well as for any delay in deployment of resources, penalties

shall also be payable by the MPA as per provisions in SLA.

The MPA shall provide digital formats and mechanism to check/record the credentials,

payroll, etc. of each resource and share the same with Society. The Society shall provide

digital mechanism to register the attendance of the resources for the purpose of calculation

of the monthly payments.

Deployment of the resources shall not entitle the resources to any permanent employment

with Society. The MPA shall undertake to indemnify Society against any such claims by the

personnel deployed by them.

The applicant should not assign or sublet the selection or deployment to any other agency.

Based on the organogram, the details of the resource requirements are as follows:

5.1. Category and Grades of the resources The resources required are categorized as given below and each category will have different grades

of employees.

Category Grades in hierarchy

Executive G1 < G2 < G3

Officer G1 < G2 < G3

Manager G1 < G2

Senior Manager G1 < G2

5.2. Head Office Head Office will form the official address for all communication and transaction with regard

to the performance of the service agency. Head Office will provide support services for the

implementation of the project. The following departments are envisaged at the Head Office

which provide support and enable the smooth implementation of the scheme at field level.

Head Office will have the following staff for managing all districts across Maharashtra:

S. No. Job Profile Min. Qualification Min. Experience Indicative

number of

resources



1. Senior Manager G2 A First Class

Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then experience

should be

considered)

>15 years 2

2. Senior Manager G1 A First Class

Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then experience

should be

considered)

>10 years 3

Work Profile and skills requirement:

Should have experience in a health insurance/ healthcare service delivery set up for

at least 5 years.

Project Management skills, should have led projects for at least 4 years

Human resource management skills, should have at least 50 people reporting to him

directly or indirectly

The departments to be functional in the head office are as follows:

5.2.1. Call Center

Call Center has executives and supervisors to handle all the incoming and outgoing phone

calls 24 x 7. The call center manager responsibilities will include the following:

Send call center reports to the Society on daily basis

Ensuring sufficient manpower in each shifts

Take necessary measures to minimize missed calls and call drops

Ensuring reporting and escalation of unresolved calls to the Society.


Exposure to customer care and grievance redressal required.

Should have work experience in process driven/SLA defined environment.

Should be able to communicate in Marathi, Hindi and English

Familiarity with call center application



Officers and manager should have experience in managing executives reporting to

them

For officers and managers, service quality management skills and training on areas

like 6 sigma required

Call Center will require the following indicative staffing:


number of

resources

1. Executives G1 Graduate degree > 1 years 100

2. Officer G1 Graduate degree > 3 years 5

3. Officer G2 Graduate degree and

MBA/ or equivalent

degree in PG (If not MBA

then +2 years’ experience

should be considered)

> 2 years 2

4. Manager G2 Graduate degree and

MBA/ or equivalent

degree in PG (If not MBA

then + 2 years’ experience

should be considered)

> 7 years 1

5.2.2. Grievance

Grievance team is required for monitoring and grievance redressal purpose. The

responsibilities include:

Monitor patient grievance and resolve it by assigning the grievance to the right

department or personnel for addressing the grievance

Confirm the satisfactory resolution of the grievance from the

patient/beneficiary/any other stakeholder

Monitor feedback received from patients/beneficiaries/any other stakeholders and

take necessary actions to address and resolve the grievance

Handle grievance redressal

Escalate unresolved/unsatisfactorily resolved grievances to the Society for necessary

action




number of

resources

1. Manager G2 Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then + 2 years’

experience should

be considered)

> 7 years 1

2. Executive G2 Graduate degree > 2 years 6


Exposure to customer care and grievance redressal required.

Should have work experience in process driven/SLA defined environment.

Should be able to communicate in Marathi, Hindi and English.

Familiarity with call center application

Officers and manager should have experience in managing executives reporting to

them

For officers and managers, service quality management skills and training on areas

like 6 sigma required

Exposure to healthcare and insurance/service sector preferred.

5.2.3. Training and Capacity Building

This department will arrange for workshops/training sessions for the capacity building of

Staff. The required training to the trainers will be arranged by the Society:

One training programme per quarter on Health Insurance Administration and claims

processing, for approx. 15-20 professional staff.

Training programme including refresher trainings for Hospital Network Providers one

in a month.

Training for Aarogya Mithras based on the functions

Evaluation of attendees

Evaluation of the feedback

Submission of training report to Society after every training


number of



resources

1. Manager A First Class

Graduate degree

with postgraduate

degree /MBA

preferred

> 7 years 2

2. Officer G3 A First Class

Graduate degree

with postgraduate

degree /MBA

preferred

>4 years 2


Experience in planning, content creation and conducting trainings .

Should have experience in training delivery

Fluent communication in Marathi, Hindi and English required

Skills in IT(MS office) is mandatory

Exposure to healthcare and insurance/service industry preferred.

5.2.4. Empanelment

Empanelment wing with required staff will empanel the hospitals in the network as per the

Scheme guidelines and monitor the compliance. The empanelled agency will have to

understand the scheme and its objective to achieve and deliver the desired results of the

scope of work. The required training to understand the RGJAY application and the

empanelment module in the application will be provided by the Society or the agency

appointed by the Society. It will be mandatory for the proposed manpower to attend the

training and achieve a satisfactory performance level in the training.

The agency has to provide adequate manpower for empanelment of hospitals, so as to

ensure free flow of daily MIS and ensure that progress of scheme is reported to Society in

the desired format on a real-time basis.

The team will have to understand the Memorandum of Understanding that will be signed

between the hospital and TPA/Insurance/RGJAYS and its resultant legal binding to ensure

that the hospitals have a clear understanding of the scheme and the contract clauses while

signing the MoU with TPA/Insurance/RGJAYS. It shall also be possible for them to provide

any clarifications to the hospitals on this regard.

Empanelment team responsibilities area as follows:



To assist the Society in developing empanelment criteria for Network Hospitals and

dialysis centers.

To assist the Society in identifying the Hospital Network Providers and networking

with them.

Visit the enlisted eligible and possibly willing hospital/dialysis centers to explain the

scheme and contract conditions of RGJAYS.

Support the hospital/dialysis center to apply for empanelment online along with

necessary photos and declarations and to ensure the completeness of the

application submitted.

Associate with RGJAYS to scrutinize the received application and coordinate with the

hospitals to receive the incomplete details, if any.

Associate with RGJAYS to do infrastructure audit of the hospitals and then grade it

appropriately in a structured predefined format.

Maintaining proper record and documentation of the empanelment process of each

hospital, infrastructure audit and scoring results. It shall also include the recording of

the rejection/approval pending reasons of the applied hospital.

Coordinate with Society for conducting the Empanelment Disciplinary Committee

meeting

Ensure that all rejected hospitals are communicated about the reasons of rejection.

Keeping the track of applications which are rejected by society, identifying those

which are eligible for resubmission after six months and facilitate them to resubmit

the application, if eligible.

Negotiation of the rates with the hospitals and finalizing the rates within a

predefined Turnaround Time.

Providing alerts to the Society on the hospitals which are exceeding the TAT in the

negotiation of rates and taking necessary actions to resolve the issues.

Ensuring the signing of the MoU with the hospitals and the TPA.

Addressing any other challenge that comes its way during the empanelment process

and resolving the issues in consultation with the Society within the minimum

specified time.

Reporting the status of empanelment to the Society on a regular basis as decided by

the Society.

The indicative list of manpower required for empanelment is as follows:


number of

resources

1. Manager G2 MBBS /MBA > 7 years 1



2. Manager G2 DPH/MHA > 7 years 1

3. Officer G3 MBA (Marketing) > 4 years 4

4. Executives G2 Graduate degree > 2 years 4

5.2.5. Health Camps

Health Camps are to be conducted by the network hospitals in various Taluka Head

Quarters/ Gram Panchayats/ Municipalities/ Municipal Corporations.

The responsibilities of the health camp team include:

Assist the network hospitals in conducting medical camps and ensure that the

hospitals follow health camp policies of the Society.

Ensure that the network Hospitals provide necessary screening equipment and the

required specialists and other para-medical staff for the health camp

To ensure, support and monitor that each of the Network Hospitals organizes Health

Camps as per schedule and all Taluka Head Quarters/ Gram Panchayats/

municipalities/Municipal Corporations are covered in the health camp programme.

The health camp department will require the following staff:


number of

resources

1. Manager G2 A First Class

Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then experience

should be

considered)

> 7 years 1


Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then experience

should be

> 4 years 4



considered)

5.2.6. Audit

The audit team will be responsible for medical audit and will:

Ensure that all the stakeholders adhere to the highest level of medical ethics.

Provide pre-authorization support to the Society.

Review and reanalyze the preauth rejection cases, pre-auth cancelled cases, claims

rejection cases, etc.

Attend to complaints from beneficiaries received directly or through Aarogyamithras

for any deficiency in services by the hospitals

Ensure proper care and counseling for the patient at network hospital by

coordinating with Aarogyamithras and hospital authorities.

Carry out surprise audits at hospitals at regular intervals and submit report to the

head office

Other responsibilities of audit team include

Ensure claims are paid within the prescribed benefit package and also ensuring the

quality of service being delivered. (At least 25 percent of the cases i.e. those

admitted in the hospital and receiving treatment and auditing of all network

hospitals at least once a year need to be conducted.)

Audit of the enrolment rejection cases, all calls received at call center, grievance

redressal performance, outbound calls, claims pending cases, etc.

The social audit mechanism is as follows:

A letter from Hon‘ble Chief Minister/Health Minister/Society will be dispatched directly to

the address of the beneficiary soon after discharge of the patient (as evident from online

details) enquiring about his present status of health after the treatment under the scheme.

It provides details of the claim such as disease suffered, surgery/therapy done, package

amount approved, enquires about the satisfactory services rendered, etc. A self-addressed

postage paid inland letter is attached to this letter to get specific feedback from beneficiary

about the quality of services, behaviour of Aarogyamithra and hospital staff and his opinion

about the scheme etc. These feedback letters are analyzed and any adverse reporting is

attended to immediately by the grievance department and field staff and resolved. Further

they are uploaded online and made available to the approving officers for viewing of the

feedback letter from the beneficiary facilitating them to analyze the case in totality and

initiate necessary action such as pending of the claim, referring the case to field staff or to

disciplinary committee in case of service deficiency.

The Audit department will require the following staff:




number of

resources

1. Manager G2 Specialist Doctor

/MBBS

> 7 years 1

2. Executive G2 A First Class

Graduate degree

> 2 years 4

The Audit team will be reporting to CEO of the society directly.

5.2.7. IT & MIS

The MIS department will ensure the free flow of daily MIS and ensure that progress

of scheme is reported to Society in the desired format on a real-time basis.

The IT & MIS department will ensure that the entire process of back office

operations of e-preauthorization, claim settlement, grievance redressal, and other

activities dependent on the portal are maintained on real-time basis.

Under MIS the collection, collation, analysis and reporting data on a real -time basis is

required.

The MIS department will also coordinate and collect hourly information from

Aarogyamithras, District team and regional team and generates reports as desired

The department should have capability to analyze the data on real time basis.

Candidate with experience in using Business Intelligence tools and other statistical

frame works for continuous monitoring is preferred.

The IT team will provide IT support to the Society.

The manpower resources required are:


number of

resources


Graduate degree in

IT related fields and

MBA/MCA or

equivalent degree

in PG (If not MBA

then experience

should be

considered)

>7years 1



2. Executive G2 A first Class

Graduate degree in

IT related field

>2 years 6

5.2.8. IEC Publicity

Publicity will be an integral component in driving the vision of the programme to the masses

and will ensure that proper publicity is given to the scheme.

The responsibilities include the following:

Awareness Generation among the beneficiaries particularly in the rural areas and

more specifically among the vulnerable sections of the community such as women &

children, Schedule Caste and Schedule Tribe population

Assist in developing the publicity materials including brochures, banners, display

boards, TV ads, print ads, interactive awareness creation meeting in the villages etc.

to be displayed in public places.

Provide continuous feedback to the State Nodal Agency on the methodology and

effectiveness of IEC activities.


number of

resources


Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then + 2 years’

experience should

be considered)

> 7 years 1

5.2.9. Back Office support

This include functions like Accounts, HR and administration


number of

resources




Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then experience

should be

considered)

> 7 years 1


Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then experience

should be

considered)

> 4 years 3

5.3. Regional Office Regional offices will be established at the regional headquarters which forms the one point

contact for the Head office to coordinate with regional and district administration. The

details of regions are provided under Annexure K. The major departments required in the

regional offices are empanelment, Operations, Audit, Vigilance and back office support

team.


number of

resources/Region

1 Senior Manager G1 A First Class

Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then + 2 years’

experience should

be considered)

> 10 years 1

Empanelment

2 Manager G1 A First Class >6years 1



Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then + 2 years’

experience should

be

considered)/MBBS

3 Executives G2 A First Class

Graduate degree

>2 years 1

Operations

4 Manager G1 A First Class

Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then + 2 years’

experience should

be considered)

>6years 1


Graduate degree

>1 years 1

Audit

6 Manager G1 MBBS >6years 1


Graduate degree

>1 years 1

Back Office Support


Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then + 2 years’

experience should

be considered)

>6years 1




Graduate degree

>1 years 7

Vigilance


Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then + 2 years’

experience should

be considered)

>6years 1

5.4. District Office

District Office will have a district team in charge of monitoring the operations of each

district in Maharshtra. The major departments of district office are health camps & IEC,

Operations, Audit, Vigilance and back office support.

The District level Manager Responsibilities are as follows:

Coordinate and monitor the Aarogyamithra services, health camps, beneficiary

services and trouble shooting.

Coordinate with network hospitals, public representatives, district administration

under the district collector and other stake holders.

Ensure proper and timely conduct of medical camps as per the schedule, arrange for

canvassing for the camp, mobilize patients and follow up beneficiaries.

The district level medical auditors/district coordinator responsibilities are as follows:

Conducting concurrent audits of services delivered by Network Hospitals (At least

25% of the patients undergoing treatment or treated are to be covered under audit)

Auditing quality of service provided to the beneficiaries

Auditing, at least once a year, the medical facilities available in the network hospitals

The Health camp coordinator will work in close liaison with the network hospitals and in

consultation with District Collector and District Development Officer (DDO) for conducting

health camps successfully. The coordinator will also work in coordination with publicity

department, villages, NGOs, etc. for mobilizing the beneficiaries to the camps. The

coordinator will follow up with the referred patients to ensure that they approach the

network hospitals for treatment.

The indicative numbers are given below:




number of

resources/District


Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then + 2 years’

experience should

be considered)

> 7 years 1

Health Camps & IEC

2 Officer G3 A First Class

Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then + 2 years’

experience should

be

considered)/MBBS

> 4 years 1


Graduate degree

> 1 year 2

Operations

4 Officer G2 A First Class

Graduate degree

and MBA/ or

equivalent degree

in PG (If not MBA

then + 2 years’

experience should

be considered)

>2 years 1


Graduate degree

>1 years 1

Audit



6 Officer G2 MBBS >2 years 1

5.5. Aarogyamithras/Hospital Support Staff

Aarogyamithras will provide strong facilitation mechanism under the scheme not only to

guide the beneficiary right from his door step but also to create awareness among rural

illiterate poor for effective implementation of the scheme. Further it was contemplated that

the facilitator may be selected among the local populace for effective communication

among these rural poor.

Responsibilities of Aarogyamithras/Hospital Support staff include:

Maintain Help Desk at Reception of the Hospital.

Receive the referred patients

Verify the documents of the patients.

Facilitate the Patient for enrolment, registration, consultation and admission.

Liaison with Hospital Coordinator /administration of the hospital.

Counsel the patient regarding treatment/surgery/therapy.

Facilitate early evaluation and posting for surgery/therapy.

Facilitate hospital send proper pre-authorization.

Follow-up preauthorization procedure and facilitate approval.

Follow-up the beneficiaries before and after surgery/therapy.

Facilitate payment of transport charges as per the guidelines.

Facilitate cashless transaction at hospital.

Facilitate discharge of the patient.

Obtain feedback from the patient.

Counsel the patient regarding follow-up.

Follow-up the patient referred by the hospital during the camps.

Coordinate with the Medical officers for any clarifications.

Send death reports and daily MIS of patients

Facilitate Network Hospital in conducting Health Camps as scheduled

Spread the awareness about the scheme and the scheduled camps in the villages.

Mobilize the patients for camps.

Following up the patients identified in the camp to report to network hospital.

Coordinate with local PR Bodies, Village organizations (VOs), Women Health

Volunteers and Self-Help Groups for effective implementation of the scheme.

Move around the villages and encourage patients to come to avail the benefits of the

scheme.

Educate villagers about the scheme and distribute brochures and other material.

Report as per the defined reporting structure.



The hospital support staff/aarogyamithras’ are required to serve during night shifts in

certain hospitals and in rotation. The facilitator shall be ready to work in any hospital and in

any location as decided by the Society.

The following qualifications are to be ensured while selecting Aarogyamitas.

Graduate degree from a recognized university

Good communication skills

Prefers to move around the villages

Functional knowledge of computers

Proficient in Marathi Language

5.6. Field Level staff

S. No. Job Profile Min. Qualification Min.

Experience

Indicative

number of

resources

1 Officer G1 Relevant Graduation preferably

First Class (MSW preferred and

relevant experience)

3 years 90 ( 1 per 4

talukas)

2 Executives G3 A First Class Graduate degree 2 years ~1500

3 Executives G2 A First Class Graduate degree 1-2 years

4 Executives G1 A First Class Graduate degree 0-1 years

5.7. Indicative salary benefits

Category Grade

Base

Component

Variable

Component

/ Bonus (%

of base

comp.)

Location Based Allowance *

**Hardship Allowance

Monthly Travel

Allowance

As per actual

(Depending upon Role)

Monthly Communic

ation Allowance

As per

actual

Category A

Category B

Category C

Executive

G1 4500 8% 2000 1500 1000 1000 Upper limit

1000 Upper limit

400 G2 6500 8% 2000 1500 1000 1000

G3 7500 8% 2000 1500 1000 1000

Officer

G1 11000 8% 2000 1500 1000 1000 Upper limit

1500 Upper limit

400 G2 19000 8% 2000 1500 1000 1000

G3 22000 8% 2000 2000 1000 1000

Manager G1 30000 8% 4000 2500 - 1000 Upper limit

2000

Upper limit

1000 G2 38000 8% 4000 2500 - -

Senior Manager

G1 55000 8% 10000 5000 - - Upper limit

2000

Upper limit

1000 G2 70000 8% 10000 5000 -



Note: * Location Based Allowance

o Category A Locations: Mumbai, Mumbai Suburbs, Thane and Pune.

o Category B Locations: District locations Nagpur, Nasik, Amaravati

Aurangabad.

o Category C Locations: All other district locations

Figures and components mentioned above are indicative and may change

** Hardship Allowance will be given to the locations where for living and working in a

potentially dangerous area.

The grades of the resources provided by the manpower agency will be based on the results

of the interview taken by the Society. The qualification and experience will also be

considered while deciding the grades. The minimum qualification and experience required

for each grades are given below. In each category, it is mandatory that the resources shall

attain minimum 70% of the marks in interview. In other case, the resource will only be

considered for a lower level of grades.

Category Grade Qualification Years of Experience

Executive G1 Relevant Graduation preferably First Class

0 to 1

G2 Relevant Graduation preferably

First Class

1 to 2

G3 Relevant Graduation preferably First Class (MSW also preferred)

2

Officer G1 Relevant Graduation preferably

First Class (MSW preferred and relevant experience)

3

G2 Postgraduate preferably with First Class

>2-3

G3 Postgraduate preferably First

Class

>4

Manager G1 Relevant Post-graduation (e.g. MBBS, MBA)

>6

G2 MBBS/ Postgraduate

(MBA)/MHA/DPH

>7

Senior Manager G1 Post graduate (MBA) 10 and above

G2 Post graduate (MBA) 15 and above

In case of resource not having MBA additional two years of experience will be considered.

Society will have the final authority in deciding the grades. Resources required in call center

and grievance cell shall have previous experience in customer care and grievance redressal.

The resources shall have experience in process driven/SLA defined environment. It is



preferred that the resources provided shall have relevant experience in healthcare and

insurance service industry.

The MPAs can always provide resources with higher qualification and more years of

experience for any of the profiles. The society reserves the right to negotiate and decide on

higher grades and indicative salary of those resources.



6. Payment Schedule

The monthly cycle will be from 20th day of each month till the 20th day of the subseque nt

month. Every month the invoice will be raised on the 20th day by taking the inputs from the

Society. Feedback from the client on the attendance and performance of the resources will

be taken before submitting the invoice for a particular month. While submitting invoice, the

manpower agency shall also provide the breakup of deductions that will be made from the

salaries of individual resources. Before going live with the project, the MPA will have to take

approval from the Society on the policies that will lead to salary cuts of the resources.

The payment by Society shall be subject to applicable deductions, taxes and penalties, if

any, as well as adjustments in respect of any other dues as may be recoverable from the

MPA in respect of non-performance of any obligations under the contract.

On receipt of payments from the society the manpower agency will disburse the salaries of

the resources within 2 days. In case, if the manpower agency does not disburse the salary to

the employees within 2 days, the SLA as mentioned under section 7 will be applicable. The

agency shall not bill those resources which the society has requested for

substitution/replacement due to not meeting the expected level of performance. A resource

shall not be billable from the date of issuance of letter/email by the Society notifying the

manpower agency about the non-requirement/substitution/replacement of the resource.

Every resource provided by the MPA shall be eligible for two days leave in a month. Every

year the resources will be eligible for annual performance incentive as per the directives of

RGJAYS. It will be based on combined evaluation of performance by the manpower agency

and its approval by the Society.



7. Service Level Agreement

7.1. Service Level Objectives

The purpose of this Service Level Agreement (hereinafter referred to as SLA) is to clearly

define the levels of service to be provided by the successful applicant to RGJAYS for the

duration of this contract. SLA defines the terms of the successful applicant’s responsibility in

ensuring the timely delivery of the deliverables and the correctness of the same based on

the agreed Performance Indicators as detailed in the Agreement. This section defines

various Service Level Indicators which will be considered by Society in the Service Level

Agreement with Successful applicant.

The successful applicant has to comply with all Service Level Agreements (SLAs) defined

below to ensure adherence to project timelines, quality and availability of services.

Note: Liquidated Damages shall not be levied on the successful applicant in the following

cases:

The non-compliance to the SLA has been solely due to reasons beyond the control of

the applicant

There is a Force Majeure event affecting the SLA which is beyond the control of the

successful applicant.

7.2. SLA definition, Measurement and Monitoring The service level agreement can be defined as follows:

Implementation related SLAs

S. No. Activity Timeline Liquidated Damages

1 Submission of Performance

Bank Guarantee by the MPA

and completion of contract

signing formalities

T + 7 days Rs. 5000 per day

2 Deployment of at least 50% of

the resources required by

Society in each office( head

office, regional offices, district

offices, field offices and

Aarogyamithras)

T + 30 days For every 5 days

delay, 5% of the

management fee

payable will be

deducted from

performance

Guarantee amount

or fee payable



3 Deployment of at least 100%

of the resources required by

Society in each office( head

office, regional office, district

office, field office and

Aarogyamithras)

T + 45 days For every 5 days

delay, 15% of the

management fee

payable will be

deducted

T is the date of issue of letter of Intent to the MPA

The manpower required can be categorized into the following categories:

Senior Level Management

Middle Level

Executive Level

Whenever any resource deployed is sought to be substituted or replaced during the course

of the assignment other than on the grounds of ineligibility or non-satisfactory performance

or absence for 3 consecutive working days without reasonable cause; or where a resource

deployed leaves the assignment midway, an equally or better qualified and experienced

substitute resource shall be provided within time frame defined below at no extra cost.

Category Notice

Period

Transition

period

Replacement

timeframe (from the

day 1 of notice

period)

Liquidated

Damages

Senior Level

Management (

Senior Manager

G2 & G1)

2 months 1 month 1 month For every week

delay and for every

case of non-

compliance – 1% of

the monthly

management fee

payable will be

deducted

Middle Level

(Manager &

Officer G3 &G2)

1 month 2 weeks 2 weeks For every week

delay and for every

four cases of non-

compliance, 0.5%

of the monthly

management fee

payable will be

deducted.



Executive Level

(Officer G1 &

Executives)

2 week 1 week 1 week For every week

delay for every

three cases of non-

compliance,0.01%

of the monthly

management fee

payable will be

deducted

Delay in replacement is defined as not providing the required resources on/before the start

of the transition period thereby reducing the required transition time and affecting the

knowledge transfer.

Where the substitution is sought on the grounds of ineligibility or non-satisfactory

performance or absence for 3 or more consecutive working days without reasonable cause,

a better qualified and, as the case may be, experienced substitute resource shall be

provided forthwith at no extra cost within 3 working days . For every single non-compliance,

a penalty of 1% of the management fee payable per month will be deducted.

In case the MPA does not release the salary to the employees within the timeframe defined

under section 6, for every two days delay, a penalty of 1% of the monthly management fee

will be deducted the next month.

In the event of successful MPA’s failure to provide the resources as per contract terms and

conditions, Society reserves the right to cancel the contract, without further notice, and

proceed to deploy the manpower from alternate sources, in which event, the successful

MPA shall be liable to bear all extra cost / costs, whatsoever, which may be incurred for

alternate arrangement.

7.3. Force Majeure

For purposes of this Clause, 'Force Majeure' means at any time during subsistence of

contract an event beyond the control of the Supplier and not involving the Su pplier's fault or

negligence and not foreseeable such events may include, but are not limited to, acts of the

Purchaser either in its sovereign or contractual capacity, wars or revolutions, fires, floods,

epidemics, quarantine restrictions and freight embargoes.

If a Force Majeure situation arises, the Supplier shall promptly but not later than 30 days

notify the Purchaser in writing of such conditions and the cause thereof. Unless otherwise

directed by the Purchaser in writing, the Supplier shall continue to perform its obligations

under the Contract as far as is reasonably practical, and shall seek all reasonable alternative

means for performance not prevented by the Force Majeure event.

Force Majeure will be accepted on adequate proof thereof.



If contingency continues beyond 30 days, both parties argue to discuss and decide the

course of action to be adopted. Even otherwise contingency continues beyond 60 days then

the purchaser may consider for termination of the contract or amendment of the contract

equitably adjusted to reflect reduced scope and/or volume of services .



8. Qualification Criteria and Proposal Evaluation

8.1. Prequalification Criteria

The applicant shall be a Company registered under the Companies Act, 1956 or a

partnership registered under the India Partnership Act 1932 with their registered

office in India and should have been in existence for at least four years.

The applicants should have their office in Maharashtra.

The applicant’s organization should be a profit making one in the preceding two

financial years. The applicant should have the minimum turnover of Rs. 10 Crores or

more in each of the last two financial years (i.e. 2010-11 and 2011-12).

The applicant should also have executed a minimum of three manpower deployment

contracts involving 500 resources or more in each contract to reputed private

companies/ Public Sector Companies/Banks/Central and State Government

Departments during the preceding four year period (2008-09 onwards).

The applicant should have obtained PAN, TAN, service tax registration and PF

registration.

The applicant shouldn’t be blacklisted by any state / central govt. body / Public

Sector Undertaking for any fraudulent and corrupt practices at any point of time in

India.

The applicant should produce satisfaction / Recommendation letter from present or

previous engagements.

8.2. Evaluation and Selection Criteria

The Technical Proposals of all the Applicants scoring 70% or more marks will be considered

for Commercial Proposal evaluation. The criteria’s for commercial proposal evaluation are

as follows

The date and time of opening of Commercial Proposal responses will be intimated to

all the successful Applicants after the technical evaluation.

After opening Commercial Offers of the technically qualified applicants, they will be

determined to be substantially responsive before comparing the commercial

proposals submitted by the applicants. If there exists any discrepancy between

words and figures, the lower amount indicated will be considered.

The substantially responsive Applicant quoting the lowest price or the L1 price in the

Commercial Proposal will be identified as L1 applicant

The society will also identify other applicants as L2, L3 and so on based on the

ascending order of their quote.



On selection of a L1 applicant, the applicant will be considered for award of contract

and will be called for negotiation with the Society.

In case, the L1 applicant declines to carry out the work, the L2 applicant will be called

for negotiation with the Society. The L2 applicant will be asked to match the L1

applicant’s quote and will be considered for award of contract upon agreement. If

the L2 applicant also declines to carry out the work or match the L1 quote then the

L3 applicant identified will be similarly considered by the Society, so on and so forth.

On successful completion of negotiation, the selected applicant will be awarded the

contract.

The Society can empanel more than one agency and may allot work at L1 rate by

forming clusters of one or more districts.

8.3. Structure of the Proposal Response The technical proposal should comprise of the following documents:

Annexure – A Company Profile

Annexure – B Technical Qualification Criteria

Annexure – G Self Declaration Form for not having pending cases in court of law

Annexure – H Notarized Affidavit for being a non blacklisted firm

Power OF Attorney for the authorized person signing the proposal documents

Supporting documents for financial details of the company (Turnover and Net

Worth, Service Tax Registration, PF registration, etc. as per Annexure A)

Plan, methodology and approach etc.

Details of offices across and around Maharashtra.

All other supporting documents as per the requirements of the RFP

Commercial Proposal Response shall be as per Annexure D - Prices quoted elsewhere shall

be liable to rejection of the entire proposal response.

The applicant should take care that rate mentioned sufficiently covers the expenses

that the applicant shall incur for resources employed for the project as mentioned in

the scope of work.

The rate quoted should be exclusive of service tax, etc., as of the last date of

submission of the proposal.

The respective responses should be duly super-scribed "Technical Proposal for

Empanelment of Manpower Agency for RGJAY project "and “Commercial Proposal for

Empanelment of Manpower Agency for RGJAY project”. These cover should also indicate the

name and address of the Applicant submitting the offers and due date of the RFP is to be

specifically mentioned on the top of the envelopes.



In case the proposal is downloaded from the website, the agencies should specifically super

scribe "Downloaded from the website" on the top left corner of the envelope while

submitting the response.

8.4. Contract Negotiations The Purchaser may enter into negotiations with the preferred applicant (winner) to identify

any changes/modifications required to the Technical and Commercial proposal. The

Purchaser reserves the right to stipulate, at the time of finalization, any other document(s)

to be enclosed as part of the final contract.

8.5. Notification of Award The Purchaser will notify the successful Responsive Applicants in writing or by Fax about the

acceptance of its Proposal and the same will also include the formation of contract. Upon

the furnishing of Performance Security of the successful Applicants, the EMDs of all the

unsuccessful Applicants will be returned.

8.6. Deciding Award of Contract

The GoM reserves the right to ask for a technical elaboration/clarification in the form of a

technical presentation from the Applicants on the already submitted Technical Proposal at

any point of time.

The Applicant shall furnish the required information to RGJAYS, GoM and its appointed

representative on the date asked for, at no cost to the GoM. The RGJAYS may at its

discretion, visit the office of the Applicant any time before the issue of Letter of Award.

RGJAYS, GoM shall inform those Applicants whose proposals did not meet the eligibility

criteria or were considered non-responsive, informing that their Technical Proposals will be

returned unopened after completing the selection process.

The applicant’s names, and such other details as the proposal inviting Authority may

consider appropriate, will be announced and recorded by the GoM at the opening.

The Purchaser shall be under no obligation to accept offer received in response to this

proposal notice and shall be entitled to reject any or all offers, including those received late,

or incomplete, without assigning any reason therefore. The Purchaser reserves the right to

make changes in terms and conditions of the proposal. The Purchaser will not be obliged to

meet and have discussions with any of the Applicant and / or to give a hearing on their

representations.



9. Terms and Conditions Governing the Contract

9.1. Signing of Contract

The Selected Applicant shall execute an agreement of contract in a given format (as

in Annexure - I) within 24 hours from issue of the letter of intent from RGJAYS, GoM.

In exceptional circumstances, on request of the successful applicant in writing for

extension, RGJAYS, GoM reserves the right to grant an extension for appropriate

period after getting satisfied with the reasons given.

In addition to terms and conditions being mentioned hereunder, all terms and

conditions of the RFP and corrigenda issued will also be applicable for the contract.

At the time of signing the agreement if the work is allotted, the successful Applicant

shall submit Performance Security for 10 % of contract value in the form of Bank

Guarantee drawn on any Scheduled Bank in favor of the Rajiv Gandhi Aarogya

Society, GoM format given in Annexure F. Without this agreement will not be

executed.

9.2. Performance Bank Guarantee (PBG)

The successful applicant shall at his own expense deposit with Rajiv Gandhi

Jeevandayee Aarogya Society, an unconditional and irrevocable PBG (which is

approximately 10 % of the value of contract) for the due performance and fulfillment

of the contract by the applicant. The format for PBG is given in Annexure F.

The performance guarantee shall be denominated in the currency of the cont ract.

This performance bank guarantee will be for an amount as mentioned above. All

charges whatsoever such as premium; commission etc. with respect to the

performance bank guarantee shall be borne by the applicant.

The performance bank guarantee shall be valid until the end of three months after

the completion of the contract with the successful applicant.

The performance bank guarantee may be discharged/ returned upon being satisfied

that there has been due performance of the obligations of the applicant under the

contract after furnishing indemnity bond. However, no interest shall be payable on

the performance bank guarantee

In the event of the applicant being unable to service the contract for whatever

reason, RGJAYS would invoke the PBG. Notwithstanding and without prejudice to

any rights whatsoever of RGJAYS under the contract in the matter, the proceeds of

the PBG shall be payable to RGJAYS as compensation for any loss resulting from the

applicant’s failure to complete its obligations under the contract. RGJAYS shall notify

the applicant in writing of the exercise of its right to receive such compensation

within 14 days, indicating the contractual obligation(s) for which the applicant is in

default.

RGJAYS shall also be entitled to make recoveries from the applicant’s bills,

performance bank guarantee, or from any other amount due to him, the equivalent



value of any payment made to him due to inadvertence, error, collusion,

misconstruction or misstatement.

9.3. Validity Period of the contract The contract shall remain valid for 24 months from the date of award of contract however

the RGJAYS may alter the validity of contract with a prior notice of 1 week to the selected

applicant. The contract will remain valid for purpose of completion of work mentioned in

project scope during the validity of the contract.

9.4. Responsibilities of Applicant

The applicant is solely responsible for terms and conditions of the contract.

Consortiums are not allowed as a part of this RFP.

The responsibility of the applicant under the contract will be adhered to the project

scope. Any action taken by the RGJAYS in respect the quality and service support

shall be challenged only by the Vendor.

9.5. Resolution of Dispute In the event of any question, dispute or differences in respect of contract or terms and conditions of the contract or interpretation of the terms and conditions or part of the terms and conditions of the contract arises, the parties may mutually settle the dispute amicably.

9.6. Arbitration

In the event of failure to settle the dispute amicably between the parties, the same shall be referred to the sole arbitrator, Additional Chief Secretary, Government of Maharashtra. The award passed by the sole Arbitrator shall be final and binding on the parties.

The arbitration proceedings shall be carried out as per the Indian Arbitration and

Conciliation Act, 1996 and the rules made there under.

9.7. Conflict of Interest The MPA shall disclose to the Society in writing, all actual and potential conflicts of interest

that exist, arise or may arise (either for the MPA or to the Society) in the course of performing the Services as soon as practically possible after it becomes aware of that

conflict.

9.8. Governing Language English language version of the contract shall govern its interpretation.

9.9. Applicable Laws The contract shall be governed in accordance with the law prevailing in India, Act, Rules, Amendments and orders made thereon from time to time.

9.10. Indemnification The contractor shall indemnify the purchaser against all actions, suit, claims and dema nd or

in respect of anything done or omitted to be done by contractor in connection with the



contract and against any losses or damages to the purchaser in consequence of any action

or suit being brought against the contractor for anything done or omitted to be done by the contractor in the execution of the contract.



10. Annexures

10.1. Annexure A: Company Profile

(The following details need to be filled in by the applicant. Please note that consortiums are not allowed as a part of this RFP).

Details of the Applicant

1. Name and complete address of the firm /

Company /Organization.

2.Details of Registered office- Address:

Telephone: FAX No (s):

E-mail address: Website:

3.Income Tax Registration number (PAN):

4.Service Tax Registration No.:

5.Whether public Limited Company or Private Sector Limited Company or any

entity(Give details):

6. Turnover (In INR Crores) during the last two financial years

2011 – 2012: 2010 – 2011:

7. Net worth of the company / firm /

organization during the last two financial years.

2011 – 2012:

2010 – 2011:

8. Name and address and designation of the

persons who will represent the Applicant. ( Attach letter of authority)

9. Details of service / support network and infrastructure available in India ( if any):

10. Valid Service Tax Registration Certificate

11. Valid Provident Fund Registration

Certificate

Note: Above details are mandatory, additional sheets may be used for submission of above mentioned details. (Authorized Signatory)

(In Capacity of) Stamp:______________________________________

Place:_____________________ Date:____________________

Organization Name:_______________________________

Business Address:________________________________



10.2. Annexure B1: Technical qualification proposal checklist

Prequalification Criteria Supporting Documents required

Document Attached

(Yes / No)

Page No

1 The applicant should be a

Company registered in India under the Companies Act 1956 or a partnership registered under the India Partnership Act 1932 with their registered office in India for the last four years.

Certificate of Incorporation/

Registration

2 The applicants should have their

offices in Maharashtra, with

offices in at least 2 of the other

major cities in Maharashtra.

Letter of Undertaking by the applicant/ Provide the list of branch offices and their addresses certified by a Company Secretary or by the Auditor of the Company

3 The applicant should have a

turnover of at least Rs. 15 Crores over the last two years.

Provide the copy of the audited

balance sheet of the company, and / or certificate from the

Chartered Accountant.

4 The applicant should have positive net worth with a total turnover of

more than Rs 1 Crore for each of the last two Financial Years from

manpower sourcing related activities

Audited/Certified Annual Financial Statements and

Annual Report for the last two financial years (2011-12 &

2010-11). CA Statement regarding turnover from manpower sourcing related

activities

5 The applicant should also have

executed a minimum of three

manpower deployment contracts

involving 500 resources or more in

each contract to reputed private

companies/ Public Sector

Companies/Banks/Central and

State Government Departments

during the preceding four year

period (2008-09 onwards).

Copy of Work Order/completion certificates and supporting documents to be attached)

6 The applicant shouldn’t have been blacklisted by any state / central

govt. body / Public Sector Undertaking for any fraudulent

Undertaking from the applicant as per the format given in

Annexure - H



and corrupt practices at any point

of time in India.

7 The applicant should have

obtained PAN, TAN, service tax registration and PF registration.

Copy of PAN card of

the Agency, Copy of TAN registration certificate , Copy of

the Service Tax & PF registration

certificate [Self certified/attested

copies may be provided]

8 Submission of approach & methodology

Action Plan document covering - 1) Recruitment 2) Deployment 3) Retention 4) Administration 5) Payroll Management

9 Compliance Certificate As per Annexure B2



10.3. Annexure B2: Compliance Certificate Format

(To be enclosed with Technical Proposal) Name of the Applicant Address of the Applicant: (To be filled in by the applicant) I hereby offer to bind to terms and conditions of the contract. I do hereby agree that I shall keep my offer for a period of 90 Days from the due date of the proposal or from the date of negotiations whichever is later or for the extended period as desired by Society in addition to the period of 90 days mentioned above in the event of my offer being accepted. I shall

abide by and give my acceptance to the terms and conditions which are mentioned in this service contract governing and shall execute an agreement in the prescribed form in the

event of my offer being accepted by Society.

I also hereby undertake to sign and execute a ‘Non-disclosure Agreement (NDA)’ before award of the contract.

Yours faithfully,

Signature of the applicant with full address (To be signed by an authorized signatory

with full address of the applicant)



10.4. Annexure B3: Technical Evaluation Criteria

Technical Evaluation Criteria Score

A Reference Sites requirement of minimum 2 sites within Maharashtra= 5 marks; for every other site within Maharashtra, 1 marks each upto a maximum of 10 marks

10

B Previous experience:

No: of executed or in progress contracts deploying 500 resources or more 3 contracts = 10 marks 4 contracts = 15 marks 5 contracts or more = 20 marks

20

C Volumes per project undertaken

500 resources = 10 marks 1000 resources = 15 marks

> 1500 resources = 20 marks

20

D Approach & Methodology 1) Recruitment 2) Deployment 3) Retention 4) Administration 5) Payroll Management

25

E Presentation by the bidder 25

Total 100

10.5. Annexure C: Clarification seeking format

Sr. No Section No. Clause No. Reference/ Subject Clarification Sought

.. .. .. .. ..



10.6. Annexure D: Format for Commercial Proposal

Category Grade Indicative Number of

resources

Manpower Agency Fees per

month per resource (In. Rs)

Manpower Agency Fees per

month (In. Rs)

A B C D E = C * D

Executive G1 1500

G2

G3

Officer G1 95

G2 137

G3 40

Manager G1 70

G2

Senior Manager G1 10

G2 2

Total



10.7. Annexure E - Proposal Covering Letter

Date: ______

To The Chief Executive Officer, Rajiv Gandhi Jeevandayee Aarogya Yojana Society, 4th Floor, Aarogya Bhavan St. Georges Hospital Compound, Mumbai 400001 Phone No.: 022-22626755 E-mail: [email protected] Dear Sir Having examined the proposal document, the receipt of which is hereby

acknowledged, we, the undersigned, offer to execute job under the above-named Contract

in full conformity with the said proposal document.

We undertake, if our proposal is accepted, to deliver the services in accordance with

the delivery schedule specified in the proposal document.

If our proposal is accepted, we undertake to submit the security deposit in the form,

in the amounts, and within the times specified in the proposal document.

We agree to abide by this proposal, for the Proposal Validity Period specified in the

proposal document and it shall remain binding upon us and may be accepted by you at any

time before the expiration of that period.

Until the formal final Contract is prepared and executed between us, this proposal

together with your written acceptance of the proposal, shall constitute a binding Contract

between us. We understand that you are not bound to accept the lowest or any proposal

you may receive.

Signed: ______________________________ Date: ________________________________

In the capacity of ____________________________________ Duly authorized to sign this proposal for and on behalf of _____________________




10.8. Annexure F - Performance Bank Guarantee Form (PBG) To (Name of Purchaser) WHEREAS _____________________________________________________(Name of Supplier) hereinafter called "the Supplier" has undertaken, purchase of Contract No.________________________ dated, __________________20__ to supply _______________________(Description of Services) hereinafter called "the Contract". AND WHEREAS it has been stipulated by you in the said Contract that the supplier shall furnish you with a bank Guarantee by a recognized bank for the sum specified therein as security for compliance with the Supplier's Performance obligations in accordance with the

Contract. AND WHEREAS we have agreed to give the Supplier a guarantee:

THEREFORE WE hereby affirm that we are Guarantors and responsible to you, on behalf of the supplier, up to a total of _________________________________(Amount of the

guarantee in Words and Figures) and we undertake to pay you, upon your first written demand declaring the Supplier to be in default under the contract and without cavil or

argument, any sum or sums within the limit of ___________________________ as aforesaid, without your needing to prove or to show this grounds or reasons for your demand or the sum specified therein. This guarantee is valid until the ___________ day of ______________ 20__ Signature and Seal of Guarantors ______________________________________ ______________________________________ ______________________________________ Date __________________________________ Address: _______________________________



10.9. Annexure G - Self Declaration Form for not having pending cases in

court of law

To Chief Executive Officer,

Rajiv Gandhi Jeevandayee Aarogya Yojana Society, 4th Floor, Aarogya Bhavan St. Georges Hospital Compound, Mumbai 400001

Phone No.: 022-22626755 E-mail: [email protected]

Dear Sir,

I hereby declare that there are no pending cases against M/s______________________

(Name and Address of Applicant) with Government of Maharashtra or any other court of law.

Signature of Applicant _____________________

Business Address _______________________

Place: Date:

10.10.Annexure H - Notarized Affidavit Undertaking (to be submitted by the applicant)

We M/s ___________________ (Name of the Applicant) having head office at undertake that we are not blacklisted by the Central Government, State Governments or Public Sector Undertakings in India. Signed on behalf of M/s ________________________ (Name of Applicant) Place:

Date:




10.11.Annexure I - Draft Contract Form (CF) THIS AGREEMENT made the _________ day of __________20__ BETWEEN The Chief Executive Officer, Rajiv Gandhi Jeevandayee Aarogya Yojana Society,4th Floor, Aarogya Bhavan, St. Georges Hospital Compound, Mumbai 400001 which expression shall unless repugnant to the context or meaning thereof mean and be deemed to include its authorized agents, representatives and permitted assigns of the First Part. AND <Name of the Successful Applicant / Vendor> (hereinafter referred to as the “Contractor”) which expression shall unless repugnant to the context or meaning thereof mean and be deemed to include their successors and permitted assigns having its corporate office at <Office / communication address of the Applicant / Vendor> of the Second Part. WHEREAS the contractor has tendered for providing services to ‘CEO, Rajiv Gandhi Jeevandayee Aarogya Yojana’ as per the terms and conditions mentioned in the <Provide

Reference to the Annexure of the RFP containing the contract> of the Request for Proposal (from herein after referred to as “RFP”) and the all subsequent corrigendum’s published

document, at a value as per appointment. Whereas such proposal has been accepted and the contractor, on behalf of all his dealers, has deposited / provided Bank Guarantee to

‘CEO, Rajiv Gandhi Jeevandayee Aarogya Yojana’ , GoM for the sum of Rs. <Amount> /- (Rupees <Amount> only) as security for the fulfillment of this Agreement.

NOW IT IS HEREBY AGREED between the parties hereto as follows: The contractor has accepted the contract on the terms and conditions set out in the proposal notice No: <Proposal Document Number> dated <Date> as well all response to queries via email dated <dates of all Communication> and corrigendum issued on <dates of all corrigendum> which shall hold good during period of this agreement. Refund of deposit shall be based on the timelines, terms and conditions as has been specified in the RFP and shall form a part of the contract. In absence of any timeline specified the deposit shall after the expiration of 24 months from the date of efflux of the contract, be returned to the contractor but without interest and after deducting there from any sum due by the contractor to ‘CEO, Rajiv Gandhi Jeevandayee Aarogya Yojana’’ , GoM under the terms and conditions of this agreement.

This agreement shall remain in force until the expiry of <period of Contract> months from the date of entering into the contract or the end of <any time period of the validity of the

contract as specified in the RFP>, whichever is later, but ‘CEO, Rajiv Gandhi Jeevandayee Aarogya Yojana’, GoM may cancel the contract at any time upon giving one months ’ notice

in writing without compensating the contractor. In witness whereof the said Contractor hath set his hand hereto and the ‘CEO, Rajiv Gandhi

Jeevandayee Aarogya Yojana’ has affixed his hand and seal thereto the day and year first above written.

All terms and conditions as specified in the RFP, clarifications issued and corrigendum issued in regards to the Ref. No. : <Proposal document Number> as has been mentioned above in

the document shall stand in force unless has been expressly agreed to in writing by both the parties.



The Contractor shall be responsible to abide and shall be liable to deliver at bear minimum

to the requirements/deliverables as has been specified to in the RFP, clarifications issued and corrigendum issued in regards to the Ref. No. : <Proposal document Number> as has

been mentioned above and any higher deliverables as has been committed to by the Contractor in the Proposal or any subsequent document submitted to and accepted by CEO,

Rajiv Gandhi Jeevandayee Aarogya Yojana’ as part of award of the Contract. The following documents shall be deemed to form and be read and construed as part of this

Agreement viz: (a) <Reference to be drawn to all relevant documents such as RFP, Clarifications,

Corrigendum, Technical Proposal, Letters from Contractor accepting abidance by RFP>

IN WITNESS whereof the parties hereto have signed this on the _______day, _______month and _________year first herein above written.

Signed, sealed and delivered

By CEO For and on behalf of “Rajiv Gandhi Jeevandayee Aarogya Yojana Society”, Government of Maharashtra Signed, sealed and delivered By ------------------------------------

For and on behalf of “<vendor> ” Witnesses:

(1) (2)



10.12.Annexure J - Format for Bank Guarantee for EMD

Whereas........................... (Hereinafter called “the Agency”) has submitted its proposal dated...................... (Date of submission of proposal) for the supply of................................. (Name and/or description of the goods) (Hereinafter called “the proposal”).

KNOW ALL PEOPLE by these presents that WE..................... (Name of bank) of.................. (Name of country), having our registered office at.................. (Address of bank) (Hereinafter

called “the Bank”), are bound unto............................. (Name of Purchaser) (Hereinafter called “the Purchaser”) in the sum of _______________________for which payment well and truly to be made to the said Purchaser, the Bank binds itself, its successors, and assigns by these presents. Sealed with the Common Seal of the said Bank this ____ day of _________ 20___

THE CONDITIONS of this obligation are:

1. If the Agency (a) withdraws its proposal during the period of proposal validity specified by the

Agency in his proposal; or (b) does not accept the correction of errors in accordance with the Instructions to

agencies; or 2. If the Agency, having been notified of the acceptance of its proposal by the Purchaser

during the period of proposal validity:

(a) Fails or refuses to execute the Contract Agreement if required; or

(b) Fails or refuses to furnish the Security deposit, in accordance with the terms and conditions stipulated in the proposal document;

We undertake to pay the Purchaser up to the above amount upon receipt of its first written demand, without the Purchaser having to substantiate its demand, provided that in its demand the Purchaser will note that the amount claimed by it is due to it, owing to the occurrence of one or both of the two conditions, specifying the occurred condition or conditions.

This guarantee will remain in force up to and including sixty (60) days after the period of the proposal validity, and any demand in respect thereof should reach the Bank not later than the above date.

................................

(Signature and Seal of the Bank)



10.13.Annexure K - Details of Regions in Maharashtra

Sr.no Region Districts

1 Konkan Region Mumbai and Mumbai Suburbs

2 Thane

3 Raigad

4 Ratnagiri

5 Sindhudurg

6 Nasik Region Nasik

7 Ahamadnagar

8 Jalgaon

9 Dhule

10 Nandurbar

11 Pune Region Pune

12 Satara

13 Sangli

14 Solapur

15 Kolhapur

16 Aurangabad Region Aurangabad

17 Jalna

18 Parbhani

19 Hingoli

20 Beed

21 Nanded

22 Latur

23 Osmanabad

24 Amravati Region Amravati

25 Akola

26 Washim

27 Yevatmal

28 Buldhana

29 Nagpur Region Nagpur

30 Nagpur rural

31 Wardha

32 Bhandara

33 Gondia

34 Chandrapur

35 Gadchiroli



10.14.Annexure J - Department wise Work Profile and Skills Requirement Resource

Profile/Department

Work Profile Requirement Skills required

Senior Manager i) Should have worked in a health

insurance/ healthcare service

delivery set up for at least 5 years

Knowledge and experience of

health insurance/ healthcare

service delivery;

ii) Should have led projects for at

least 4 years

Project management; Operations in

a service delivery environment;

iii) Should have at least 50 people

reporting to him directly or

indirectly

Human resources management;

Stakeholder management;

Operations management;

Call Center &

Grievance

i) Exposure to customer care/

grievance redressal etc

fluent communication in Marathi,

Hindi & English ;

ii) Should have worked in a process

driven/SLA defined environment

familiarity with call center

applications;

iii) Should have managed executives

reporting to him/her

service quality management;

(training on areas like 6 sigma);

iV) Exposure to healthcare and

insurance / services industry

preferred

process management;

Training i) Involved in planning, content

creation and conducting trainings

Content creation;

ii) Exposure to healthcare and


preferred

Training planning & organization;

Training delivery;

fluent communication in Marathi,

Hindi & English ;

IT skills(MS office) required

Empanelment i) Should have worked in a hospital

setting





Resource

Profile/Department


service delivery;

ii) Exposure to healthcare services/

hospitals operations/ hospitals

marketing


Negotiations skills;

Marketing skills;

Basic IT skills (MS office)

Vendor management skills

Health Camps i) Interaction and coordination with

various stakeholders as a part of

normal work



service delivery;



preferred

Operations in a service delivery

environment; human resources

management;

Medical Auditor i) Interaction and coordination with


normal work



service delivery;



preferred


environment;

Audit i) Interaction and coordination with


normal work



service delivery;



preferred


environment;

IT & MIS i) exposure to IT software for MIS

reporting

Experience in roles like

system/network administrator;

ii) preparing reports, analyzing

reports and presenting to senior

management

Experience in MIS and back end

operations



Resource

Profile/Department


In case of IT support staff,

experience in roles like system

admin, network admin, etc. are

required.

IEC i) experience in media Networking

ii) IEC activities - planning and

delivery

IEC;

iii) Communication

iV) Exposure to healthcare and


preferred

HR i) Experience in recruitment, HR and

admin



service delivery;



preferred


Negotiations; Human Resource

Management

Admin i) Experience in admin roles Knowledge and experience of


service delivery;




Negotiations; Human Resource

Management

Accounts i) Experience accounting and finance Knowledge and experience of


service delivery;



preferred




Resource

Profile/Department


Negotiations; Finance and

Accounting

Regional, District &

Field Operations

i) Interaction and coordination with


normal work



service delivery;



preferred


environment;

Human resources management;

Stakeholder management;

10.15.Annexure K - Organogram

Senior Manager G1 (3)


Grievance Manager G2 (1)

AuditManager G2 (1)

EmpanelmentManager (2)

Call Centre Manager G1 (1)

Officer G3 (27) Executive G2 (6)

Executive G2 (4) Officer G3 (4)

Officer G2 (54)

Executive G2 (6)Officer G1 & G2 (5,1)

Executive G1 (100)

Health Camp Manager G2 (1)


Officer G3 (4)

Executive G2 (4)

Back Office SupportManager G2 (1)

Training Manager (2)

IT & MISManager G2 (1)

Officer G3 (3)

IEC Manager G2 (1)

Manager G1 (30)Manager G2 (27)

Executive G1 (81)

Officer G3 (2)

Executive G1 & G2 (54 & 6)

Officer G1 (90)

Executive G1, G2 & G3 (3000-4000)