The Medical Network Executive will be part of the Provider Network Team, in managing the panel clinics listings for clients/insurers, align clinics on cost containment measures, achieve clients satisfaction and maintain monthly SLAs.
- Regularly engage with clinics onsite or through meetings, calls, or emails to understand their needs and concerns.
- Schedule and conduct training sessions either on-site or off-site based on clinic preferences on portals usage to ensure they maximize the benefits of the training.
- Maintain an updated database of panel clinics and their information.
- Collaborate with relevant teams to compile and distribute monthly panel listings to clients in a timely manner.
- Monitor incoming emails regularly and prioritize responses based on urgency and SLA requirements.
- Identify areas for workflow improvement within clinics and internal processes.
- Collaborate with cross-functional teams to plan and implement projects aimed at streamlining workflows and enhancing efficiency.
- Identify the root cause of the issue, whether it's an error in cash collection or claims submission.
- Prepare thorough updates on pending cases and relevant information for meetings with insurers.
Requirements
- Degree or Diploma in any relevant field.
- At least 3 years of relevant experience in Healthcare / Third Party Administration (TPA) domain, Specialist or General Practitioners’ clinic Practice or Insurance industries
- CGI and Health Insurance Certification is preferably
- Demonstrate high attention to detail, follow-through and accuracy
- Posses learn and be curious attitude
- Self-motivated and able to work well in a team, with multi-tasking capabilities.
- Possess highly flexible and adaptable characteristic on handling ad-hoc situation.
