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Network Manager

MedNet Global Healthcare Solutions LLC

Posted on October 16, 2019

2 - 7 years Manama - Bahrain

Any Graduation. Any Nationality

Opening 01

Job Description

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MedNet Bahrain is one of the
leading managed care service organizations that caters to healthcare needs
and offers financial protection against unforeseen health risks. We are
currently seeking to hire a Medical Network Manager with the following tasks
and responsibilities:
Your Job
Manage and maintain the existing healthcare service provider
network by making routine visits to discuss and resolve network related issues
and ensure timely reconciliation with service providers
Be responsible for provider credentialing and re-credentialing
processes to ensure effective execution of services as per Munich Re s quality
standards and policies
Conduct presentations and trainings for appointed healthcare
provider staff on the MedNet and managed care concepts, and provide updates on
all related procedures in order to ensure awareness of and compliance with
Munich Re s service requirements and policies across the network
Conduct and manage provider profiling and trend analyses to
identify preferred service providers and to give recommendations to the senior
management in order to expand and enhance the provider network to offer the
best services to clients
Negotiate with healthcare service providers and manage the
contracting and renewal process within established corporate guidelines to
ensure that all services are delivered up to defined quality standards as well
as cost efficiently
Support all MedNet operations by ensuring effective coordination
and good relationships with healthcare service providers to identify, collect
and report specific data and to fulfill information and documentation
requirements
Conduct and oversee specific initiatives, such as mystery
shopping, to monitor and facilitate optimum control of fraud and abuse of
healthcare benefits, and report on critical issues to the senior management for
remediation
Perform cost-benefit analyses for the development of a provider
handbook or other printing materials in order to ensure these investments are
adding value
Your Profile
Medical degree from a university recognised by the World Health
Organisation (WHO)
5 to 7 years of experience working in a TPA or medical insurance
sector as well as 2 years of managerial experience, with a solid understanding
of insurance principles and business models
Knowledge of local healthcare system as well as all insurance laws
and regulations
Distinct analytical skills, drive and clarity in thinking with a
high quality, detailed and diligent work attitude
Excellent interpersonal skills and ability to communicate and work
effectively with all levels of the organisation with fluency in business
English and Arabic
Good negotiation and problem-solving skills
Strong customer focus
Good knowledge of Microsoft applications


IT Software

Keywords

Network Manager

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MedNet Global Healthcare Solutions LLC


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