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Network Manager

MedNet Global Healthcare Solutions LLC

Posted on October 1, 2019

5 - 7 years Manama - Bahrain

MBBS(Medicine). Any Nationality

Opening 01

Job Description

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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


Keywords

Network Manager

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MedNet Global Healthcare Solutions LLC


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