Industry: Insurance
Total Positions: 1
Job Type: Full Time/Permanent
Gender: No Preference
Salary: 1900USD - 2000USD (Monthly)
Education: Bachelor′s Degree
Experience: 4-10 Years
Location: Muscat, Oman
Skills: Networking, empanelment etc
Posted Date: 08-06-2021
Description:
Key Responsibilities
· Identify & create a health provider network as per organizational requirement.
· Willingness to travel exhaustively for empanelment and package negotiations with hospital.
·
Analyze data and design effective discount structure/ packages which are
mutually beneficial
for all stake holders.
·
Strategize & execute effective cost containment measures and
periodically demonstrate the
impact in terms of cost effectiveness.
· Build and manage strong relationships with hospital to provide seamless cashless services.
·
Design and Implement performance management for service partners
including reward &
recognition.
·
Coordination with clients and internal stake holders on a daily basis to
understand the pain
points and provide immediate effective resolution.
· Periodic presentations and reporting to all stakeholders.
· Visiting Hospitals & Maintaining Relationship with Hospitals.
· Managing Central Operation of Provider Network Management.
· Drive Network Provider projects with internal Departments & External partners.
· Coordinating with TPAs for data & other daily operations.
- Develop and strengthen the network of medical healthcare professionals (hospitals, doctors, pharmacies, clinics, etc.) across Oman.
- Analyse the quality and relevance of the current network as per the city location of insured members in the region;
- Negotiate and establish partnerships with healthcare professionals.
- Liaise on a regular basis with medical partners to ensure a smooth relationship and insured member satisfaction;
- Using medical claims’ data, analyse network development or strengthening needs;
- Secure cost-containment for medical care performed within their network:
- Evaluate the average cost of most frequent medical treatments;
- Negotiate consistent contract terms and competitive rates for medical treatment;
- Make sure that negotiated price lists are well applied and regularly updated by medical partners.
Requirements
- Bachelor Degree
- At least 4 years’ experience with Insurance Services or /and Customer Services environment is desirable.
- Excellent knowledge of insurance laws, rules and regulations to interpret, explain and provide justifications on the action taken to patients and customers.
- Excellent verbal and written English.
- Working knowledge of MS office programmes, including excel, word etc.
- Analytical, problem solving and decision making skills
· Candidates currently in Oman with NOC / Local Release (or with GCC experience).
Immediate requirements, Attractive Salary, and Benefits