Healthcare Partnership Manager
7 days ago
As a Healthcare Partnership Manager, you will be responsible for managing healthcare partnerships and maintaining an active provider network to ensure consistent service delivery. This involves onboarding and due diligence assessments as well as operational excellence.
You will contribute to the division's strategic, financial, and operational objectives through effective coordination and execution of ongoing business activities. This includes evaluating and gathering necessary information to assess TPA outpatient claims according to policy benefits, ensuring all claims documentation and procedures adhere to company and claims management requirements.
The role also involves conducting audits on claims processed by TPA to ensure appropriate controls are in place, supporting internal or external audits for the team, and ensuring efficient, prompt, and fair resolution of escalated complaints.
You will identify patterns of complaints and address them through strengthening of controls and training. Additionally, you will liaise with other operations teams on member data matters to ensure that clients visit panel clinics on a cashless basis.
Analyzing and proposing process or operational enhancements to improve efficiency is another key aspect of this role. You will conduct trainings for medical providers on product features and benefits.
Active management and oversight of third-party administrators and medical providers are essential to ensure they comply with outsourcing requirements, meet service delivery standards, and achieve cost containment initiatives. Performing annual audit and security assessments are also part of this role.
Supporting Sales & Marketing teams in Intermediary and Client Management business discussions and service reviews is crucial. You will also be a key stakeholder to lead the team to proactively manage new and existing scheme transitions and service resolution to ensure delivery of client KPIs/SLAs including day-to-day service levels, customer experience, quality measures, and compliance measures.
Developing and implementing strategic initiatives to enhance medical services and expand networks within Singapore and regionally will drive growth and profitability. Providing support in the management of medical costs, including collaboration with Healthcare, Life Operations, and Group Office on healthcare projects is also essential.
This role requires a strong proficiency with Microsoft Office, especially Excel. Excellent communication and organizational skills are also necessary. Requirements include education - diploma/degree, experience - minimum 8 years related industry experience, and personal data to be considered for this career opportunity.
- Key Responsibilities:
- Evaluate and gather necessary information to assess TPA outpatient claims.
- Conduct audits on claims processed by TPA.
- Ensure efficient, prompt, and fair resolution of escalated complaints.
- Liaise with other operations teams on member data matters.
- Conduct trainings for medical providers.
- Active management and oversight of third-party administrators and medical providers.
- Support Sales & Marketing teams in Intermediary and Client Management business discussions and service reviews.
- Develop and implement strategic initiatives to enhance medical services and expand networks.
This role offers opportunities for professional growth and development in a dynamic and innovative environment.
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