Job Description
Responsibilities
Applicants should be able to carry out the following responsibilities:
- Develop and execute strategic plan to acquire and manage HMO providers in Mediplan Healthcare's network.
- Hospital assessment, accreditation and provider education.
- Provide thorough assessment and credentialing of provider facilities.
- Ensure prompt attention and resolution to provider issues.
- Ensure effective case management/referral of enrollees on admission.
- Organize and conduct annual medical examination for entitled clients.
- Conduct staff negotiations for provider services.
Requirements
- Possess an MBBS / MBChB
- Must possess a valid practicing license with 2-5 years of post-accreditation experience, preferably within the Health Insurance / Managed Care environment.
- Must have a good knowledge of the workings of the National Health Insurance Authority (NHIA).
- Monitor provider network to ensure quality assurance, etc.