Primary Care Business Partnering, Consultant

At AIA we've started an exciting movement to create a healthier, more sustainable future for everyone.

It's about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030.

And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business.

Sound like you Then read on.

About The Role

• To manage a panel of GP Providers that provides medical services with cashless facility to cover members of AIA health insurance policies.
• To build cordial business relationship with panel providers with regular dialogues sessions, communications, and promotion/ marketing activities.
• To support claims operations and act as intermediary for operational matters between panel clinics and AIA.
• Conduct regular cost and utilization review and retrospective claims reviews, to identify outliers and manage these GP providers

Roles and Responsibilities:

Provider Engagement:

• To create the GP Clinic Dialogues presentation deck to ensure panel clinics are updated with latest information/ changes from AIA.
• To provide and receive feedback from providers by monitoring behavior and evaluating the performance of hospital panel provider based on claims utilization, market best practice, service level, adherence

Relationship Management/Communication:

• To oversee the handling of complaints from internal and external clients on services related issues by panel providers, especially issues related to claims, services related issues by clinics, suspected high cost, churning of visits, MC related issues etc.
• To conduct provider training sessions and proactively communicate with panel providers on new procedures and/or urgent updates to daily operational requirements of AIA.
• To oversee and track swift resolution of operation issues related to internal AIA processes through active operations meeting, collaboration with operation teams and interventions.
• To suggest system/process enhancements to ensure, leakages or for operational efficiency as required by Corporate Solutions Department/ Policy changes/ Regulatory changes. s and/or urgent updates to daily operational requirements.

Cost Management

• To support special projects that may incur significant savings and impact on medical inflation.

Patient Steerage Strategy

• To proactively manage the allocation and promotion of health events to preferred partners, such as Smart Hospitals and clinics that want to work with AIA for new initiatives.
• To steer patients from tertiary/ secondary care to primary care by upskilling panel clinics, increasing procedures to perform in clinics and reducing referral to hospital/ specialist clinics.

Minimum Job Requirements:

• Experienced in Private General Clinic practices
• Preferably candidates with medical background
• Good command of written & spoken English & Bahasa Malaysia
• Good knowledge of current healthcare delivery systems
• Min 4 years of working experience in the service industry, preferably in healthcare or insurance
• Good communication and interpersonal skills
• Able to work with minimum supervision
• Responsible, calm and able to plan and prioritize his/her work and other team members daily activities.