Provider Network Relations Staff (Local HMO)

Pioneer Your Insurance

Negotiable
On-site - Makati1-3 Yrs ExpEdu not requiredFull-time
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Job Description

Description

Provider Network Relations Staff

Job Summary: Cultivates and optimizes relationships with healthcare providers in the assigned area, ensuring an effective network that delivers high quality care to HMO members. 

Primary Duties and Responsibilities of the Provider Relations Staff:

  • Initiate and assist the Manager in the new and renewal contracts of prospective and accredited providers (hospitals, clinics, doctors) and in conducting provider-relations visits to existing providers, particularly those with difficult doctors, and visiting hospitals during times of suspension.
  • Data encoding and gatekeeping of Providers and Physician data in the system.
  • Educate providers on administrative policies and procedures.
  • Provide assistance to the internal team on a case-by-case basis.
  • Prepare and release warning letters, memoranda, and other similar communications to Providers and Physicians, if necessary.
  • Collate and organize reports of the team for submission to Immediate Heads.
  • Take charge in case the Immediate Head is on leave or attending business meetings outside the company.
  • Help facilitate the resolution of provider-related concerns/complaints.
  • Undertake all other tasks that may be assigned from time to time.

Job Qualifications: 

  • College Graduate (BS Nursing, Psychology, etc.)
  • With at least 3 years’ experience on the same role (Healthcare)
  • Proficient in the use of Microsoft Office tools
  • With excellent attention to detail, Organizational Savvy and Results oriented
  • Must be willing to work in Makati City 

Requirements

Please refer to job description.

Technician
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Boss

HR ManagerPioneer Your Insurance

Work Location

Pioneer House Makati, 108 Paseo De Roxas St. Legaspi Village Makati City, Metro Manila, Philippines

Posted on 02 April 2025

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