Network Management and Strategy Consultant
2 days ago
Hospital Network Partnership, Consultant Job Summary
OverviewWe are seeking an experienced Network & Provider Management Consultant to join our team at AIA Hong Kong and Macau. This role will involve managing hospital panel partnerships, provider engagement, business development, and cost management initiatives.
The successful candidate will be responsible for ensuring quality healthcare provider networks, optimizing cost strategies, and driving patient steerage toward preferred providers.
Key Responsibilities:
- Develop Performance Dialogue presentation decks using internal dashboards/ information to ensure providers are updated with AIA's direction, change of processes and aligned with AIA goals.
- Monitor provider behavior and evaluate hospital panel performance based on claims utilization, market best practices, service levels, fee schedule adherence, and fraud detection.
- Provide feedback and drive mutual improvement initiatives with providers.
Requirements:
- Bachelor's degree in healthcare management, business administration, or a related field.
- Minimum 5 years of experience in hospital operations, insurance, or healthcare industry.
- Strong understanding of hospital billing practices, medical claims processes, and insurance fraud detection.
A strong analytical mind, excellent communication skills, and ability to work effectively in a team environment are essential for success in this role.
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