Responsibilities
Development and management of our panel network through proactive engagement and recruitment of health and wellness providers.
Develop and implement recruitment, training and engagement process so as to ensure all panel providers are well equipped to render cashless services to members.
Keep up to date with market information and developments and have regular communications with internal departments to keep all stakeholders up to date.
Negotiate contractual terms with panel providers to ensure best deal is being accorded to members.
Liaise with relevant parties to resolve any outstanding issues.
Manage and maintain system data to ensure accuracy in billings.
Maintain data analytics and perform regular review on utilization trending, behaviour trending, etc.
Manages the team with regards to recruitment, training, counselling and discipline
Panel providers audit, including but not limited to case review, onsite audit, discussion with panel providers.
Investigate issues, feedbacks and complaints from members to provide resolutions to external and internal stakeholders timely.
Requirements
Adaptive to changes quickly
Communication skills
Negotiation skills
Interpersonal skills
Customer Service oriented
Result oriented
Problem-solving skills
Experience in TPA, insurance or healthcare industry
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