Deputy Manager, Provider Management

Prudential BSN Takaful Berhad


Date: 2 weeks ago
City: Kuala Lumpur
Contract type: Full time
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 inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.

Leadership and Support: Assist the Manager in leading the provider network team in executing the tiering and steerage initiative for panel hospitals, and support engagement with internal and external stakeholders.

Preparation and Documentation: Assist in preparing comprehensive reports and materials for hospital steerage negotiations, document findings and issues identified during reviews, and ensure all panel hospitals are properly licensed and have signed agreements/contracts.

Performance Reviews and Audits: Support the Manager in conducting performance reviews and audits on all panel hospitals, ensuring team members conduct audits in strict accordance with SOP.

Reporting and Presentation: Assist in preparing and disseminating performance review and audit reports, and support the presentation of findings and updates to the Head of Unit and HOD.

Collaboration and Liaison: Collaborate with the Manager to liaise with hospital management on complaints or issues raised by clients, agents, claims assessors, or management, and handle complaints and cases reported by panel hospitals, following up until resolution.

Compliance and Accuracy: Ensure panel hospital information across various channels is up-to-date and accurate, and assist in identifying shortfalls and service gaps between HAS and panel hospitals, providing solutions and training.

Financial Management: Assist in recording all refunds received from audit reviews, collaborate with Finance and IT to ensure proper allocation of refunds, and support the monitoring of all HAS payments and prompt processing within the SLA in accordance with SOP.

Additional Responsibilities: Ensure all failed HAS Hospital Payment Automations are processed within the SLA in accordance with SOP, follow up on pending items, and perform any other tasks as assigned by the Manager related to hospital network and claims matters

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective 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.

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