Network and Healthcare Management & Strategy, Analyst (1 Year Contract)
AIA
Kuala Lumpur
Permanent
Full-time
2 months ago
Position Objective: To manage a panel of Providers that provides medical services with cashless facility to covered members of AIA health insurance policies. To build cordial business relationship with panel providers with regular dialogues sessions, communications, and promotion/ marketing activities. To support claims operations and act as intermediary for operational matters between panel clinics and AIA Health Services. Roles and Responsibilities: To create the GP Clinic Dialogues presentation deck to ensure panel clinics are updated with latest information/ changes from AIAHS. To provide and receive feedback from providers by monitoring behavior and evaluating the performance of hospital panel provider based on claims utilization, market best practice, service level, adherence. To oversee the handling of complaints from internal and external clients on services related issues by panel providers especially issues related to claims, services related issues by clinics, suspected high cost, churning of visits, MC related issues etc. To conduct provider training sessions and proactively communicate with panel providers on new procedures and/or urgent updates to daily operational requirements of AHS. To oversee and track swift resolution of operation issues related to internal AHS processes through active operations meeting, collaboration with operation teams and interventions. Cost Management. To support special projects that may incur significant savings and impact on medical inflation. To proactively manage the allocation and promotion of health events to preferred partners, such as Platinum Hospitals and clinics that want to work with AIA for new initiatives. To steer patient from tertiary/ secondary care to primary care by upskilling panel clinics, increasing procedures to perform in clinics and reducing referral to hospital/ specialist clinics. Proactively create a calendar of events for each year either by matching to provider's calendar and/or populating an internal calendar. Minimum Job Requirements: Degree in Health or Life Sciences, Allied Health or relevant disciplines. Working experience in healthcare or managed care or insurance industry. Knowledge in healthcare management, experience in nursing and medical advancement. Good verbal and written communication skills, problem solving skills, able to manage people, fundamental knowledge in accounting principles, good analytical skills, proficiency in basic computer operating software like MS Office, willing to travel for job assignments.
