Health Provider Network Management Senior Specialist (Chuyên viên Cấp cao Hệ thống Đối tác Bệnh viện Phòng khám)

Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.

Job Description

Strategic Planning, Development and Execution

·       To support the design and execution of hospital network expansion strategies, including partnerships, acquisitions, and affiliations.

·       To conduct market analysis and feasibility studies to identify growth opportunities and service gaps.

·       To contact and connect with vendor and managing vendor correspondence in view of proposal request, proof of concept, preparation of requirement, probing of the effectiveness and prepare an executive summary for selection of vendor.

·       To onboard providers on PVA platforms according to the procurement process in a timely manner.

·       To onboard preferred providers according to PPN framework and strategy design.

Network Optimization

• To evaluate hospital performance metrics and recommend improvements in service delivery, cost-efficiency, and customer outcomes.
• To collaborate with cross-functional teams to streamline referral pathways, care coordination, and resource utilization.
• To be able review, renew agreement with prior discussion as when the time is right and due. Also to be able to discuss any dispute encountered in the process, observing fraud and collusion which warrant an instant of termination of service agreement.
• To review & revisit the expectations of KPI delivery from providers and ensure the procurement requirement. Evaluation and submission of detail audit, seeking change is being executed and comply to risk & compliance requirement.

Stakeholder Engagement

·       To self-drive in communicating and preparing requirements of project including budgeting the expense proposal, conducting meetings with internal & external stake holders to discuss, strategist and to execute the Health projects.

·       To be able to support the team in conducting the presentation to selected hospital for specific group of client/VIP program on fast service, any additional exception service for selected Health riders. 

·       To support manager in training, to share the expectations of insurer in dealing agents or leaders, implementation, and communication on watchlist action to high claims agency especially in suspicion of misconduct & fraud is evident.

Technology & Data Integration

·       Support implementation of health information systems and digital tools to enhance network connectivity and data sharing.

·       Monitor data quality and analytics to inform decision-making and performance tracking.

Others

·       To be able to continuously attend / involve with training for personal and career development.

Undertake projects / other work and duties allocated by management as and when required.

Job Requirements

a. Qualification

Degree in Economics, Business Administrative, Business Management, etc.

b. Experience

Preferably experience in Business Development, Insurance business and Business Strategic Planning and Health Management will be an advantage. Working at an insurance company or banking for at least 3-5 years.

c. Knowledge, Skills & Attributes

Insurance/Legal/Health management and project management, Business Development.

Possess knowledge of Life Insurance claims processing.

Computer literate and familiar with MS Excel, MS Word & MS PowerPoint.

Self-assured and results oriented

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.