Medical Network Manager

3 weeks ago


Hong Kong, Central and Western District, Hong Kong SAR China HSBC Full time

Transforming Healthcare with HSBC

HSBC Life is a world-class institution where you can specialize in Insurance and enjoy the advantages of being part of a leading global international bank. We are currently seeking a high-calibre professional to join our team as an Assistant Manager, Medical Network Management.

Key Responsibilities

This is a specialized role to support the Medical Services Department. The person is expected to have solid experience in private healthcare and medical insurance industry to support clinic and medical supply chain management including network strategy planning and development.

Key Accountabilities

  • Executing strategies to effectively manage a top-notch provider network and TPAs
  • Assisting in the creation of disease management programs that are suitable for members
  • Assisting in the agreed fees negotiation and the utilization of specialized medications to control costs
  • Supporting a team of professionals in network management and providing guidance and support to achieve objectives
  • Supporting ad hoc projects and initiatives as needed

Quality Assurance

  • Investigation and handling of complaints, disputes and disciplinary action of providers
  • Communicating with providers, including providing feedback on member experiences, updates on clinical best practices, and results of quality assurance reviews
  • Enhancing provider satisfaction and performance

Data Analysis

  • Monitor and review clinical quality indicators and performance measures
  • Maintaining a monthly record of providers undergoing disciplinary inquiries and the decisions to delist, suspend, or monitor from the panel
  • Conducting utilization analysis of the usage of medical services
  • Assisting in the regular deep dive analysis based on publicly available statistics and market intelligence

Requirements

  • University graduate
  • At least 5 years of experience in medical network development for healthcare/insurance industry
  • Experience working in clinics and claims services is highly desired
  • Excellent written/spoken English/Chinese (incl. Mandarin)
  • Project Management
  • Vendor Management & Procurement
  • Microsoft Office
  • Exceptional communication and interpersonal skills
  • Keen attention to detail and an aptitude for problem solving
  • Strong written and oral communications skills


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