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AIA Network Partnership Manager

7 days ago

Kuala Lumpur, Kuala Lumpur, Malaysia AIA Hong Kong and Macau Full time

Hospital Network Partnership, Consultant

Overview:

AIA Hong Kong and Macau is seeking a highly skilled Hospital Network Partnership, Consultant to join our team. In this role, you will play a key part in managing hospital panel partnerships, provider engagement, business development, and cost management initiatives.

Key Responsibilities:
  • Panel Provider Partnerships:
    • Assess new panel provider applications and provide recommendations based on credentialing guidelines.
    • Support the Hospital Specialist Review Committee by coordinating documentation and site visits.
  • Provider Engagement:
  • 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.
Relationship Management & Communication:
  • Oversee the handling of complaints from internal and external clients related to provider services, claims, and guarantee letter (GL) turnaround times (TATs) and service level agreements (SLAs).
  • Track and ensure swift resolution of claims and GL issues through operations meetings and interventions.
  • Conduct training sessions and communicate with panel providers on new procedures and operational updates.
Alliance Management:
  • Build strong, win-win business relationships with healthcare providers.
  • Develop and distribute marketing materials to promote Preferred Providers and drive patient steerage.
  • Strengthen collaboration between agencies, corporate clients, and Preferred Providers.
  • Drive steerage initiatives to Preferred Providers.
  • Manage the allocation and promotion of health events to Preferred Providers.
Cost Management:
  • Support the execution of the Network Strategy to achieve medical inflation targets.
  • Support special projects that drive significant savings and improve medical cost management.