Hospital Network Partnership, Specialist

1 week ago

Kuala Lumpur, Malaysia AIA Full time

At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.
- It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030._
- And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business._

Sound like you? Then read on.

About the Role

This role will be responsible to manage and enhance relationships with healthcare panel providers, particularly hospitals, ensuring alignment with organizational goals, cost efficiency, and high-quality service delivery.

Roles & Responsibilities:
Panel Provider Management
- Coordinate documentation and facilitate site visits to support the Hospital Specialist Review Committee in provider selection and review.

Provider Engagement & Performance Management
- Develop and deliver performance review presentations using internal dashboards and analytics to communicate AIA’s strategic direction, process updates, and performance expectations.
- Monitor and analyze provider performance, focusing on; i) Claims utilization trends, ii) Service quality and turnaround times, iii) Adherence to fee schedules and iv) Detection and mitigation of potential fraud or abuse.
- Provide constructive feedback and collaborate with providers on continuous improvement initiatives.

Alliance & Relationship Management
- Foster strong, collaborative, and mutually beneficial relationships with healthcare providers.
- Enhance coordination between internal stakeholders (e.g., agencies, corporate clients) and Preferred Providers.
- Lead initiatives to promote steerage towards Preferred Providers, optimizing service quality and cost-effectiveness.

Cost & Network Strategy Management
- Support the implementation of the Network Strategy to meet medical cost containment and inflation control targets.
- Contribute to special projects aimed at driving cost savings and enhancing the efficiency of medical cost management.

Minimum Job 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.
- Preferred background: Medical doctor, nurse, or experienced professional in hospital billing, claims, or provider network management.
- Strong understanding of hospital billing practices, medical claims processes, and insurance fraud detection.
- Excellent interpersonal and negotiation skills to manage hospital relationships effectively.
- Strong problem-solving abilities and attention to detail.
- Effective communication and training capabilities.
- Ability to analyze medical and financial data to support cost containment initiatives.
- Proficiency in Microsoft Office and familiarity with hospital IT systems (e.g., HIS, e-claims platforms) is an advantage.
- Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives._

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