Medical Analytics: Utilization & Provider Insights

Prudential Indonesia (PT Prudential Life Assurance)

Jakarta Pusat

On-site

IDR 223,200,000 - 446,400,000

Full time

4 days ago

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Job summary

Prudential Indonesia (PT Prudential Life Assurance) is seeking a Medical Doctor (MD) to join our medical analytics team. You will conduct utilization reviews per national guidelines, support cost containment with providers, and help evolve workflows and tools for utilization management.

The role requires strong clinical judgement, analytical skills, and proficiency in MS Office; experience with BPJS casemix is a plus. We value equality of opportunity for all applicants across diverse backgrounds.

Qualifications

MD with minimum Bachelor's degree.
Strong clinical judgement, analytical, and problem-solving skills.
Knowledge of MS Office; Excel & PowerPoint advantageous.
Having experience with BPJS casemix is an advantage.
Knowledge of provider relations and claim processes.

Responsibilities

Analyze utilization review according to national guidelines (OJK requirement) and internal policies.
Support cost containment initiatives with healthcare providers (drug formulary, EBP, Package Pricing, etc).
Adapt to evolving workflows, tools, and utilization management practices.
Support Medical Review and Analytics Hospital (Cost trend, Utilization trend, High-cost provider, High-cost diagnosis, Readmission, Length of Stay (LOS)).