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    Medical Provider Management-Assistant Manager - Dubai, United Arab Emirates - NEXTCARE Claims Management LLC

    NEXTCARE Claims Management LLC
    NEXTCARE Claims Management LLC Dubai, United Arab Emirates

    6 days ago

    Default job background
    Full time
    Description

    Summary:

    The Assistant Manager for MPM is locally responsible to efficiently and effectively manage the Medical Provider networks. The Assistant Manager MPM is expected to negotiate and facilitate the onboarding of Medical Providers with an objective to have a diverse portfolio of medical services which are financially beneficial to the Allianz group.
    The Assistant manager is responsible for supporting MPM Manager/ Senior Manager in leading the team and manage the assigned region Medical providers. The position reports to MPM Manager/ Senior Manager of assigned region.

    Main Tasks:

    Responsibilities will include, but are not limited to, the following:
     Support and drive the strategy devised by the Global & Regional Head of MPM.
     Deliver assigned objectives within full scope of Medical Provider Management within the region individually or in co-ordination with a team of Medical Provider Management resources locally, where applicable.
     Work/lead on projects (Global/Regional/Local Regulatory) as required for the business continuity in the region.
     Consolidation, Integration, Maintenance & Development of a single AP Medical Provider Network in the Region
     Uses judgment, diplomacy and confidentiality with respect to the complete procurement process, ensuring integrity.
     Withholds the reputation of company, beneficiaries, payers and all other parties involved.
     Ability to deliver on targets set locally, regionally and globally.
     Responsible for the Provider Network expansions per local business requirements within optimum cost
     Acquires medical services in accordance with MPM strategy and manage empanelment request from Medical Providers to provide comprehensive network at an optimized cost.
     Responsible to implement the Local & Regional DOAP (Delegation of Authority Policy)
     Manages negotiations with Medical Providers to reduce average claim cost per network.
     Provide regional and local Medical provider cost analysis to facilitate Cost Containment & Financial Savings impact
     Tariff negotiation and renegotiations/ new service inclusions with the providers to maintain competitive tariff in line with defined benchmarks.
     Enhances the Provider revenue structure to generate savings in line the regional MPM strategy.
     Responsible for compliance, maintenance and updates of Desk top procedures, checklists, DoAP
     Responsible for supporting periodic reporting of MPM centrally and regionally
     Performance monitoring and assessments of Medical Providers in terms of delivery, quality, pricing and efficiency
     Maintain and update all the required trackers / reports/Dashboards required within MPM function
     Maintain valid Medical Provider data, hierarchy, and links for the region and update web interactive portal services.
     Manages the negotiation of health checkup packages / Gate keeper arrangements / special schemes arrangements with Medical providers with specification of SLA.
     Provides weekly/monthly reports to the Manager and daily updates on priority matters.
     MPM Complaint Management by investigation, closure and escalations as needed
     Adapt to the entire Allianz Partners Technical Infrastructure within all lines of businesses required to successful delivery of the assigned objectives/tasks.
     Closely works with all the departments within the organization to resolve MPM related queries
     Guarantee Medical Provider Management business continuity, efficiency and service levels within the region
     Other activities/ special projects as directed/ assigned by the MPM Senior Manager and Regional Head of MPM MEA from time to time.
    28855 | Product Management | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent

    Minimum Requirements:

    To be successful in this position you will need to have the following skills/ experience:
     Bachelor's / Master's Degree; Medical background preferred.
     3-5 years' experience in a network administration environment (preferably gained in hospitals, insurance companies, TPAs).
     Physically fit to carry out duties.
     Logical thinking mind set and ability to solve problems
     Strong communication (verbal & written), presentation and interpersonal skills
     Fluent in written and verbal English, and Arabic; other languages are an advantage
     People management and motivation
     Analytical skills
     Business and commercial acumen
     Relationship and stakeholder management
     Able to use a range of standard (Microsoft Office) and non-standard IT applications to support and enhance the work;
     Legally permitted to work in the country of operations
     Local medical/health industry knowledge
     Flexibility and can work autonomously
     Ability to adapt communication style based on target audience
     Strong organization, prioritization and time management
     Process minded
     Target driven
     Can do attitude
     Able to work in a fast pace, high delivery work environment
     High level of dependability, accountability, and integrity.
     Ability to work under pressure.
     Ability to adapt to change, meet the changing demands of work environments, any delays or other unexpected demands.

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