Manager, Provider Support
6 days ago
Manager, Provider Support page is loaded
Manager, Provider SupportApply locations Kuala Lumpur (Takaful) time type Full time posted on Posted 14 Days Ago job requisition id 25020056
Prudential's purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people's career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.
Responsibilities:- Leadership and Engagement: Lead the provider network team in executing the tiering and steerage initiative for panel hospitals, and engage with internal and external stakeholders.
- Preparation and Documentation: Prepare comprehensive reports and materials for hospital steerage negotiations, meticulously document all findings and issues identified during reviews, and ensure all panel hospitals are properly licensed and have signed agreements/contracts.
- Performance Reviews and Audits: Conduct thorough performance reviews and audits on all panel hospitals to ensure the highest quality of services, and ensure team members conduct audits in strict accordance with SOP.
- Reporting and Presentation: Prepare and disseminate detailed performance review and audit reports, present findings and updates to the Head of Unit and HOD, and ensure the preparation and dispatch of SOAs for hospitals by the team in accordance with SOP.
- Collaboration and Liaison: Collaborate closely with the Head of Unit to liaise with hospital management on complaints or issues raised by clients, agents, claims assessors, or management, and handle complaints and cases reported by panel hospitals, following up until resolution.
- Compliance and Accuracy: Ensure panel hospital information across various channels (Corporate Website, Navigator Apps, systems, etc.) is up-to-date and accurate, and identify shortfalls and service gaps between HAS and panel hospitals, providing solutions and training.
- Financial Management: Accurately record all refunds received from audit reviews, collaborate with Finance and IT to ensure proper allocation of refunds to the relevant certificates, and ensure strict monitoring of all HAS payments and prompt processing within the SLA in accordance with SOP.
- Additional Responsibilities: Ensure all failed HAS Hospital Payment Automations are processed within the SLA in accordance with SOP, ensure strict follow-up and resolution of all pending items in accordance with SOP, and perform any other tasks as assigned by the HOD related to hospital network and claims matters.
Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.
About UsWe are Prudential. For Every Life, For Every Future.
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