Senior MPM Officer

at  Allianz Partners

JOB OVERVIEW:

The MPM Senior Officer is responsible to efficiently and effectively support the Medical Provider network in assigned zones and responsible for special local, regional and global assigned projects.
The incumbent should perform a wide variety of technical and administrative tasks for the MPM Department to ensure accurate and effective data maintenance, circulation, safekeeping and flow of vital information, procedures and contracts as defined by corporate MPM strategy. This Position reports to Assistant Manager / Manager of the assigned region. The MPM Senior Officer is also responsible for managing relationships with medical providers, ensuring compliance with company policies, and optimizing the quality of healthcare services

Responsibilities will include, but are not limited to, the following:

• Support Network Development: Assist the Manager in developing and maintaining a network of healthcare providers, including hospitals, physicians, and ancillary services and negotiation of Provider revenues
• Conducts Gap analysis of Provider Network as assigned
• Manages empanelment request from Medical Providers including but not limited to:
• Receipt, registration, and up-to-date record maintenance with consistent informs in coordination with unit members.
• Responds to the request and follow up for completion of case file.
• Concludes Medical contract preparation activities by coordinating verification and approvals by appropriate levels of authority.
• Contract Documentation preparation, coordination and filing: Contract documentations and mail room operations management and coordination
• Provider database: Responsible for accurate and up to date records of medical provider database; Maintains and periodically monitors valid Medical Provider data, hierarchy, and links for the region and update web interactive portal services.
• Technical infrastructure: Responsible to learn and adapt to the company’s technical environment and work on all the applicable systems and projects across all Allianz Partners entities.
• Assist In Provider negotiations as assigned
• Provider Relations: Help establish and maintain positive relationships with medical network providers, addressing concerns and issues under the guidance of the Manager/ Asst. Manager.
• Compliance Support: Ensure that MPM contracts and documentations adhere to relevant internal and external regulations, accreditation standards, and organizational policies. Responsible for compliance of TOM and DTP’s
• Performance Monitoring: Assist in monitoring network performance metrics such as cost, quality, and accessibility, and help implement improvement initiatives.
• Team Collaboration: Work collaboratively with the local regional and global teams and also closely work with network Operations providing necessary support and assistance.
• Interdepartmental Coordination: Collaborate with other departments including Business development, CRM, Operations and Finance to support overall organizational goals.
• Reporting: Prepare and present reports on network performance and activities to the Manager.
• New service addition: Responsible for all new services addition as per standard pricing model within agreed TATs
• Provider Training: Conduct Medical Provider training per requirement and maintain updated training material in coordination with the line Manager.
• Special negotiations: Health checkup packages / Gate keeper arrangements / special schemes arrangements with medical providers with specification of SLA.
• Network List: Periodic defined local and regional network list preparation and distribution to defined channels
• Medical Provider Complaint management: Record maintenance , coordination to resolve or escalate as needed
• Reporting and Analytics: Prepare regular reports on network performance, including provider utilization, cost trends, and quality metrics.
• Coordinates with Payers and Medical providers for Bipartite and Tripartite agreements, Gate Keeper Addendums.
• Participates in specialized projects and assignments related to Medical Provider Management, as required.