Job description
Some careers have more impact than others. If youre looking for a career where you can make a real impression, join HSBC and discover how valued youll be. Whether you want a career that could take you to the top, or simply take you in an exciting new direction, HSBC offers opportunities, support and rewards that will take you further.
HSBC Life is a world-class institution where you can specialize in Insurance but enjoy the advantages that come with being part of a leading global international bank. Insurance is about people, and the promises they make. At HSBC Life we help deliver on these promises by providing a wide variety of life insurance products and services to our clients throughout the Asia-Pacific region.
Our employees enjoy a dynamic and innovative workplace and a world of opportunities to develop their careers in a high-profile growing business segment. We empower our team of high-performing individuals to build skills and explore new experiences to realize the full potential of being part of HSBC.
Together we pursue efficient ways of working. We harness the latest data and technology solutions to achieve meaningful outcomes for our clients. The protection we offer creates broad and lasting impact, helping clients to be healthier, more productive and more confident in their futures.
We are currently seeking a high calibre professional to join our team as a
Manager, Medical Network Management.
Principal Responsibilities Manager, Medical Network Management (GCB 5)
This is a specialized role to support the Medical Services Department. The person is expected to have solid experience in the private healthcare and medical insurance industry to support clinic and medical supply chain management including network strategy planning and development.
Job descriptions:
Relationship Development
- Creating and 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
- Negotiating agreed fees and the utilization of specialized medications to control costs
- Leading 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
- Profiling providers by collecting and analysing information about their practice patterns
- Conducting utilization analysis of the usage of medical services
- Conduct regular deep dive analysis based on publicity available statistics and market intelligence
Business Support
- Providing individual case management to coordinate with providers for special member requests
- Educating providers of the products and handling their inquiries and administrative matters
- Creating and maintaining an operating procedures manual for network management
- Credentialing and periodic re-credentialing providers
- Negotiating agreed fees for renewal and the utilization of specialized medications to control costs
Requirements
- University graduate
- At least 10 years of experience in medical network development for the 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 communication skills
Youll achieve more when you join HSBC. www.hsbc.com/careers HSBC is committed to building a culture where all employees are valued, respected and opinions count. We take pride in providing a workplace that fosters continuous professional development, flexible working and opportunities to grow within an inclusive and diverse environment. Personal data held by the Bank relating to employment applications will be used in accordance with our Privacy Statement, which is available on our website.
Issued by The Hongkong and Shanghai Banking Corporation Limited.
HSBCLIFE2024