- Create and maintain relationships with medical profession community
- Recruit new provider and perform provider contracting activities including fee negotiation, cost containment, quality review, orientation, clinic accreditation to meet with selection requirement and credential process
- Compromise and reach an agreement with provider as approved by manager independently
- Understand and reinforce the need of compliance to the existing agreement terms and conditions
- Handle %26amp; manage the daily operation to ensure all tasks identified function appropriately
- Prepare and issue contract for authorized signature and follow up on contract return
- Process contracting activities: new ,renew, extension and termination align with company%26rsquo;s policy; verify supporting documents and required information; update at designated company application
- Provide training , consolidated feedback and provide enquiry support in related to provider agreement
- Process and follow up request from internal stakeholders
- Review and monitor provider performance to ensure provider comply with cost control, quality review and other administrative guidelines. Make termination recommendations to department head for final approval of provider performance not acceptable
- Make effective use of historical and other benchmark data to ensure competitive pricing with contacted providers
- Verify data for daily work from various reports including daily , monthly report to ensure high accuracy rate of processing
- Work closely with claims team and provider for the improvement of claims payment processing efficiency
- Execute effective communications with related teams and network providers as required
- Communicate effectively with internal stakeholders in order to gain their support with the healthcare strategy
- Follow up enquirers from providers and other teams reacted to network providers
- Ensure compliance of the set KPI, job duties and department guidleines
- Active participation in team meetings , trainings as required
- Participation in special tasks/ projects as assigned
- Lead project preparation task, assist department head on preparing documentation, escalate potential project issues, provide recommendation and suggestions
- Implement agreed tasks and completed in agreed timeline
- Close collaboration to work within the team and other departments to achieve set objectives
- Resolve reported issue / problem identified with recommendations for solutions
Qualification: bachelor degree required
Fluency in written and spoken English %26amp; Cantonese is required
Experience:
At least 4 years of experience of working in medical disciplines is required Background in healthcare insurance market or healthcare provider market or relevant transferable skills and knowledge Able to carry out effective coaching and training Good communication and negotiation skill problem solving and decision making skills Demonstrate ability to deal with difficult people Experience in project implementation High levels of integrity and trust
Candidate with more experience will be considered as Network Management Manager