Search by job, company or skills

Prudential Assurance

Panel Doctor & Hospital Network Senior Specialist

Early Applicant
  • a month ago
  • Be among the first 50 applicants

Job Description

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 included assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact on the business, and we support our people's career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.

Collect, check, prepare opening/closing procedures, evaluate the appraisal clinic to Ensure that the contract information with the clinic meets the requirements and regulations within the committed time.
. Collect, check, prepare opening/closing procedures, evaluate the clinic to ensure contract information with the clinic as required, regulations within the committed time. Prepare contracts (new or renewing contracts), price comparison tables, collect valid documents, ensure the accuracy of regulations, processes & content. Process risk assessment
. Responsible for drafting contracts (new, renewed contracts), drafting price comparison tables, contacting and collecting valid documents to ensure work is performed in accordance with regulations, procedures & 100% accurate content Perform risk assessment
. Manage and be in charge of the work related to the nationwide network of clinics
. Manage and be in charge of all work related to the clinic network nationwide.
Reconcile of payment cost
Reconcile payment costs
. Monitor email and hotline related to panel doctor work
In charge and management of the clinic network
  • In charge of managing the clinic network
  • Collect Collect, check, prepare opening/closing procedures, evaluate the appraisal clinic to ensure that the contract information with the clinic meets the requirements and regulations within the committed time.
  • Collect, check, prepare opening/closing procedures, evaluate the appraisal clinic to ensure that the contract information with the clinic meets the requirements and regulations within the committed time.
  • Prepare contracts (new, renewing contracts), price comparison tables, collect valid documents, ensure the accuracy of regulations, processes & content
  • Responsible for drafting contracts (new, renewed contracts), drafting price comparison tables, contacting and collecting valid documents and certificates to ensure work is carried out in accordance with regulations, procedures & 100% accurate content
  • Process risk assessment and Annual refesh
  • Conduct risk assessment when there is a change or periodic assessment
  • Coordinate with other departments/colleagues/partners to solve problems related to evidence and records from the clinic
  • Coordinate with other departments/colleagues/partners to solve problems related to evidence and records from the clinic
  • Enhance material for examination and assessment, using Panel doctor web to update new information
  • Participate in developing clinic evaluation criteria according to company regulations
  • Participate in developing and monitoring clinic evaluation criteria according to company regulations
  • Reconcile payment costs and confirm statements with clinics/hospitals, check documents from PK/BV sent back and submit to the payment team for signing.
  • Reconcile payment costs and confirm statements with clinics/hospitals, check documents sent from clinics/hospitals and submit them to the payment team for signing.
  • Handling customer complaints related to clinics
  • Handling customer complaints related to clinics/hospitals
  • Support clinics to solve complex cases and feedback from customers
  • Support clinics/hospitals to solve complex cases and feedback from customers
  • Planning, build the process and system,
  • Planning, building the reporting process
  • Develop additional processes to OM according to QA-QC noted: Management process of partners providing examination and appraisal services The process of opening/stopping cooperation, the process of managing original documents.
  • Develop additional processes to OM according to QA-QC noted: Management process of partners providing examination and appraisal services The process of opening/stopping cooperation, the process of managing original documents. Original document management process,
  • Develop detailed instructions for the working team: Guide to the price entry process, Guide to the risk assessment process, etc.
  • Develop detailed instructions for the working team: Guide to the price entry process, Guide to the risk assessment process, etc.
  • Data consolidation/analysis/setup and build up: PD budget, PD Manual - OM, PD capacity, PD implementation plan,
  • Data consolidation/analysis/setup and build up: PD Budget, PD Manual - OM, PD Capacity, PD Action Plan,
  • Monthly Report: Code lab report, Monthly report (Code lab report, PD web usage report, Case acceptance rate report, SLA24h random check report, QA-QC monthly update report & Follow the corresponding actions of the reports.
  • Monthly Report: Code lab report Prepare monthly reports (Code lab report, PD web usage report, Case acceptance rate report, SLA24h random check report, QA-QC monthly update report & Follow the corresponding actions of the reports.
  • Project & Activities: Participate in and implement the project in collaboration with the departments that sign the Master contract: Analyze and synthesize data/ Contribute to the process/ Provide information/ Coordinate the process of vendor selection, Risk assessment, contract signing, etc. Track and monitor QA-QC activities
  • Project ... Project implementation in coordination with departments to sign Master contract: Data synthesis analysis/ Process contribution/ Information provision/ Process vendor selection coordination, Risk assessment, contract signing... Monitoring and supervising QA-QC activities
  • Monitoring and promoting clinics/hospitals to update the retention of medical records on the doctor web panel according to the department's project
  • Monitoring and promoting clinics/hospitals to update the retention of medical records on the doctor web panel according to the department's project
  • In charge of being on duty and answering emails and hotlines related to panel doctor work
  • In charge of being on duty and answering emails and hotlines related to panel doctor work
  • Other tasks assigned from management level
  • Perform other tasks assigned from management level
  • Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organization regardless 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.

    More Info

    Industry:Insurance

    Function:Healthcare

    Job Type:Permanent Job

    Skills Required

    Login to check your skill match score

    Login

    Date Posted: 20/10/2024

    Job ID: 96947119

    Report Job

    Hi , want to stand out? Get your resume crafted by experts.

    Similar Jobs

    Senior Tender Specialist

    BuymedCompany Name Confidential

    Senior Product Application Specialist CT MRI Open for Radiographer

    Fujifilm VietnamCompany Name Confidential