Medical Network Management Lead

4 weeks ago

Hong Kong, Central and Western District, Hong Kong SAR China Prudential plc Full time

At Prudential, we are committed to being partners for every life and protectors for every future. Our purpose drives everything we do, creating a culture where diversity is celebrated and inclusion is assured. We provide a platform for our people to excel and make an impact, supporting their 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, developing and managing medical provider networks and direct billing services. Key responsibilities include:

  • Providing insights from research and analytics data to develop health strategies and prepare presentation materials for senior management.
  • Developing and managing medical provider networks and direct billing services through business contract negotiation, arrangement of agreed fees, provider training, settlement processes, and third-party agreements.
  • Ensuring excellent customer experience and value from network providers through performance monitoring, quality assurance, feedback management, daily servicing issue handling, and implementation of process improvement initiatives.
  • Engaging corporate clients, agencies, and distribution through education, communication, and engagement activities to promote direct billing services.
  • Researching and recommending opportunities for medical network development, aligning with the company's H&P strategy through business analysis, competitive benchmarking, network coverage, and specialty reviews.
  • Supporting the delivery of key improvement initiatives through provision of user requirements.
  • Maintaining business continuity by providing administrative support as necessary.
  • Providing support to ad hoc projects and proposition initiatives as required.

    Requirements for this role include:

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

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