Provider Relations Executive/Senior (Panel Clinics, TPA, Medical Insurance)
Full-time
Senior Executive
6 months ago
About The Opportunity
We are currently seeking dynamic professionals to join our managed Healthcare team to drive the development and expansion of our.....
About The Opportunity
We are currently seeking dynamic professionals to join our managed Healthcare team to drive the development and expansion of our Healthcare service provider network.
What You'll Be Doing
- Contribute to the development and management of our providers network through proactive sourcing, recruitment and engagement of the panel of clinics 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.
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