Performs other responsibilities and duties periodically assigned by immediate manager in order to meet business requirements.
Prepares regular reporting to management on metrics relating to business, operations, risk, compliance, workforce, etc. or statutory authorities on regulatory metrics.
Develop procedures for reporting, extract, collate and populate data to reporting template.
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including but not limited to Medical, Dental, Diagnostics, Physiotherapy clinics.
Conduct training to panel providers as required.
Identifying and remediating operational short-falls and claims.
Negotiate contracting and re-contracting process with healthcare service providers within corporate guidelines and ensure that all services provided are delivered according to SLAs.
Maintain monthly statistical reports to facilitate benchmarking and performance management of network operations for management decision making.
Manage and maintain system data relating to new codes, accounts, pricing, etc.
Gather and analyze claims paid data, utilization data and benefit design information to assist in the development of strategies for contracting and re-contracting.
Provide feedback to providers regarding their performance under the terms of their contract, identify and address quality of care and service issues.
What We Are Looking for
Prior experience in Provider Relations/Provider Contracting role within a TPA/medical insurance environment is preferred
but not essential.
Possess industry knowledge related to managed Healthcare services will be an added advantage.
Highly developed interpersonal, communication and stakeholder management skills.
Excellent organisational skills and exceptional eye for details.
Passionate about driving change to improve business outcomes.
Advanced level of proficiency in claims processing and issue resolution.
We regret to inform that only shortlisted applicants will be notified for a virtual interview.
To learn more about our Organization, please visit https://alliancehealthcare.com.sg.
Describing insurable risk to your clients, designing appropriate insurance solutions and negotiating and managing the best deal in the global insurance market for them.
Regional coordination with existing clients as well as broker partners globally.
Managing relationships with underwriting partners.
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