Provider Business Partner, Network and Healthcare

**At AIA we've started an exciting movement to create a healthier, more sustainable future for everyone.**

**Sound like you Then read on.**

**WE ARE LOOKING FOR.....**To manage and grow a panel of healthcare providers that provides medical services with cashless facility to covered members and policyholders of AIA health insurance policies. To build cordial business relationship with panel providers and ensure medical claims costs are contained effectively with regular performance dialogues and monitoring of utilization with the use of analytics. To support claims operations and act as intermediary for operational matters between panel providers and AIA Health Services.

Roles & Responsibilities:
**Network Management**
- Hospital Panel-ship
- To provide the relevant assessment study on new panel provider applicant and provide recommendations based on credentialing guidelines and requirements.
- To support the process of deliberation by the Hospital Specialist Review Committee which includes documentation and site visits.
- Provider Engagement
- To create the Performance Dialogues presentation deck from internal dashboards.
- To provide and receive feedback from providers by monitoring behavior and evaluating the performance of hospital panel provider based on claims utilization, market best practice, service level, adherence to fee schedule and possible fraud for mutual improvement.
- Contracting
- To support the negotiation of provider contract to gain strong commercial improvements and delivery of major cost savings.
- To be ensure necessary contracts are renewed before expiry, i.e. package pricing contracts and to continuously follow up to ensure contracts are closed within a reasonable time period.
- Relationship Management/Communication
- To oversee the handling of complaints from internal and external clients on services related issues by panel providers especially issues related to claims and GL TATs & SLAs.
- To oversee and track swift resolution of claims and GL issues related to internal AHS processes thru active operations meeting and interventions.
- To conduct provider training sessions and proactively communicate with panel providers on new procedures and/or urgent updates to daily operational requirements of AHS

**Business Development**
- To build cordial win-win business relationships with providers.
- To coordinate business events with providers including meetings, official openings, launches, etc.
- To develop and disseminate marketing materials related to packages and Platinum provider with assistance from Provider Business Associates.
- To develop and bridge the relationship between Agency with package and Platinum providers.
- To follow up and close the Addendums for package pricing and terms renegotiations with providers.

**Alliance Management**
- To support the identification suitable providers to Platinum status.
- To support the identification suitable of package pricing partners
- To drive steerage to Platinum and package pricing partners
- To proactively manage the allocation and promotion of health events to preferred or package partners.
- Proactively create a calendar of events for each year either by matching to provider's calendar and/or populating an internal calendar.

**Health Analytics**
- To provide actionable insights from the relevant dashboards related to providers and medical inflation for the empanelment of providers.
- To provide analysis and tracking of medical inflation and claims savings from
- Platinum providers
- Package Pricing
- Contract renegotiations of discounts
- New panels
- To perform quarterly bill reviews of top incurred providers/diagnosis/procedures for identifying major cost contributors in the bill.
- To perform bill reviews as needed to support Performance Dialogues, empanelment and daily operational needs.
- To perform due diligence for package pricing using analytics.

**Cost Management**
- To support the team's managers in executing the Network Strategy to achieve targeted medical inflation targets.
- To maximize cost savings on panel negotiations
- To maximize the impact of package pricing by expanding to all viable procedures and hospitals nationwide.
- To support special projects that may incur significant savings and impact on medical inflation.