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To develop and implement provider negotiation and management initiatives including recruiting, contracting, commercial negotiation and maintaining a robust business relationship with providers. This includes designing and conducting an effective delivery of communication with panel providers. In addition, to ensure reasonable and customary charges practices by providers and to provide support to system related to operational needs and requirement.

Job Descriptions:

• Develop and implement provider negotiation and management initiatives including contracting, commercial negotiations, provider manuals and KPIs to drive strong commercial improvements and delivery of major cost savings.   
• Drive the provider negotiation implementation plan and the periodic review of the financial / non-financial performance - monitor provider behavior and evaluate performance of  hospital panel provider based on claims utilization, market best practice, service level, adherence to fee schedule and possible fraud.
• Manage and maintain the healthcare provider network for AIA Shared Services Malaysia
• To provide the relevant assessment study on new panel provider applicant and provide recommendations based on credentialing guidelines and requirements.
• To maintain cordial and beneficial networking with key persons of the providers, including visits to proactively build close business relationship and identification of new potential providers. 
• Support initiatives with team colleagues in the development of provider portal/provider communication, triage/preferred network strategies, clinical pathways (if any), concurrent review processes, and others medical management related improvements.
• Support initiatives with team colleagues in the development of provider portal/provider communication, triage/preferred network strategies, clinical pathways (if any), concurrent review processes, and others medical management related improvements.
• Develop relationships with counterparts in other AIA markets to promote and share learnings and best practices, working in conjunction with Group Healthcare team.
• Assist in the design/development of healthcare reports relating to provider management and utilisation management to assist in the monitoring of clinical and financial outcomes.
• Performs other responsibilities and duties periodically assigned by supervisor in order to meet operational and/or other requirements.

Build a career with us as we help our customers and the community live healthier, longer, better lives.

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