Provider Business Partnering, Consultant

12 hours ago

Kuala Lumpur MYAIA Malaysia AIA Full time 60,000 - 120,000 per year

FIND YOUR 'BETTER' AT AIA

We don't simply believe in being 'The Best'. We believe in better - because there's no limit to how far 'better' can take us.

We believe in empowering every one of our people to find their 'better' - in the work they do, the career they build, the life they live and the difference they make. So that together we can support even more people - including our own - to live Healthier, Longer, Better Lives.

If you believe in better, we'd love to hear from you.

About the Role

To manage and enhance relationships with healthcare panel providers, particularly hospitals, ensuring alignment with organizational goals, cost efficiency, and high-quality service delivery.

Panel Provider Management

  • Evaluate and assess new panel provider applications in accordance with established credentialing guidelines.
  • 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:
    • Claims utilization trends
    • Service quality and turnaround times
    • Adherence to fee schedules
    • Detection and mitigation of potential fraud or abuse
    • Other indicators related to panel provider's performance
  • 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.

Education and Experience

  • 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 analyse medical and financial data to support cost containment initiatives.
     

Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.

You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.

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