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Physician Engagement, Specialist

Physician Engagement, Specialist

AIA MalaysiaKuala Lumpur, Kuala Lumpur, Malaysia
30+ hari lalu
Penerangan pekerjaan

AIA Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia

Overview

Join to apply for the Physician Engagement, Specialist role at AIA Malaysia .

At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone. It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030. And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from, some of the most inspiring and supportive leaders in the business.

Sound like you? Then read on.

About The Role

To manage cost and cost containment efforts for covered members and policyholders of AIA health insurance policies related to specialist costs. To build cordial business relationships with specialist doctors, medical directors and panel providers and ensure medical claims costs are contained effectively with regular performance dialogues, scorecard management and monitoring of utilization with the use of analytics.

Roles & Responsibilities

  • Specialist Management

New Specialist Panel-ship : manage and grow a network of specialist doctors who provide cashless and cost-efficient service to covered members including recruitment, utilization management, and termination.

  • Provide assessment studies for new specialists and recommendations based on credentialing guidelines and cost requirements.
  • Provider Engagement
  • Create an engagement platform with medical directors, hospital management and specialists to highlight cost and behavior of specialists for improvement.

  • Provide and receive feedback from specialists, medical directors and heads of departments by monitoring behavior and evaluating performance based on claims utilization, market best practice, service level, adherence to fee schedule and possible fraud for mutual improvement.
  • Relationship Management / Communication
  • Arrange and manage specialist communication and engagement sessions, and feedback loops to ensure cost is managed.

  • Scorecard Management and Review : create and manage specialist doctors’ scorecards to monitor cost.
  • Engage with medical directors and specialists to explain and understand scorecards.
  • Monitor specialist costs and decide on actions such as removal or watchlist placement.
  • Internal & External Communication : provide timely communications to internal teams (e.g., AHS) and external providers and hospital management about status of specialists.
  • Proactively manage specialist inquiries and coordinate with hospital network partnership team.
  • Health Analytics : provide actionable insights from dashboards related to specialists and from data and audit findings on cost and quality indicators (e.g., average cost, Length of Stay, bill size statistics) for scorecard management.
  • Support quarterly bill reviews of specialists from specific hospitals or specialties to identify major cost contributors.
  • Identify pricing for packages and cost containment initiatives with appropriate procedures and providers.
  • Cost Management
  • Participate in executing the Specialist Management Strategy to achieve targeted medical inflation and maximize cost savings on specialist costs.

  • Support special projects with potential significant savings and impact on medical inflation.
  • Minimum Job Requirements

  • Degree in Health or Life Sciences, Allied Health or relevant disciplines
  • Working experience in healthcare or managed care or insurance industry
  • Knowledge in healthcare management, experience in nursing and medical advancement
  • Good verbal and written communication skills, problem solving skills, people management, awareness of basic accounting principles, strong analytical skills, proficiency in MS Office, ability to travel for job assignments
  • Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.

    You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.

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