Manager, Medical Network Management

6 months ago


Hong Kong, Hong Kong SAR China Prudential plc 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.

This role will oversee and lead Employee Benefit Medical Network, by developing and managing medical provider network and direct billing service.

Job Responsibilities:

Provide insights from research / analytics data to develop health strategies, develop proposals and preparation of presentation materials for senior management Develop and manage medical provider network and direct billing service through business contract negotiation, arrangement of agreed fees, provider training, settlement process and third-party agreements Ensure excellent delivery of customer experience and value from network providers through performance monitoring, quality assurance, feedback management, daily servicing issue handling and implementation of process improvement initiatives Engage corporate client, agency and distribution through education, communication and engagement activities to uplift utilization of direct billing service Research, recommend opportunities on development of medical network and align with company's H&P strategy through business analysis, competitive benchmarking, network coverage and specialty reviews Support delivery of key improvement initiatives through provision of user requirements Maintain business continuity by providing administrative support as necessary Provide support to ad hoc projects and proposition initiatives arising from time to time

Job Requirements:

Degree holder with experience in medical network, clinical or healthcare operations Minimum 6 years in managing contract negotiations involving medical network providers and with at least 4 years' experience on Employee Benefits, Group Life Insurance Attentive to details with good analytical, coordination and organizational skills Good presentation, negotiation and communication skills; strong business acumen Excellent command of English and Chinese (written and spoken) including Putonghua Experience in healthcare insurance / healthcare provider market / project management is an advantage Knowledge in claims and medical terminology is an advantage

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