Assistant Manager, Care Services

Great Eastern Life; Kuala Lumpur; On-site; MYR 100,000 - 150,000; Full time

Job summary

An established industry player is seeking an Assistant Manager in Care Services to join their dynamic team. This role is pivotal in ensuring the accurate processing of guarantee letters and supporting the Call Centre with technical and medical inquiries. The ideal candidate will have a degree in Nursing or a related field, along with significant clinical experience, particularly in emergency and intensive care settings. You'll be part of a dedicated team that values integrity and initiative, working in a supportive environment that encourages professional growth and development. If you're passionate about healthcare and eager to make a difference, this opportunity is for you.

Qualifications

• Degree in Nursing or related field with 2-3 years experience.
• 5-8 years clinical experience in A&E, ICU, or OT preferred.

Responsibilities

• Review and process guarantee letter cases accurately and timely.
• Support Call Centre in handling technical and medical issues.
• Assist Care Manager in resolving complaints related to guarantee letters.

Skills

Interpersonal Skills

Communication Skills

Initiative

Medical Terminology Knowledge

Problem-Solving Skills

Education

Degree in Nursing or Healthcare

State Registered Nurse or Medical Assistant

Tools

Hospital Patient Management System

Billing System

Job description

Job Description - Assistant Manager, Care Services (220001YP)

Job Number:

220001YP

Discover the GREAT in your career.

As a LIFE company, our customers are at the heart of all that we do. Being one of Asia’s leading insurers for over a century, we have built a long-lasting legacy of trust with our customers over many generations. At the foundation of this trust is Integrity, Initiative, and Involvement – from the way we treat every customer relationship with honesty and transparency, to our proactive approach of delivering the best possible solutions in both life and general insurance.

The Role:

• To adjudicate, review and process guarantee letter cases.
• Pre-certifies cases for issuance of guarantee letter in accordance with Company’s requirements and guidelines.
• Ensure initial and final guarantee letters are issued accurately and timely.
• Support Call Centre CSEs in handling technical/medical issues.
• Ensure cases of fee dispute are handled and resolved within targeted TAT.
• Back-up Call Centre operations.
• To attend to any other tasks assigned from time to time.
• To assist the Care Manager Handle/resolve issues and complaints related to guarantee letter issuance.
• To assist the Care Manager in handling of cases where medical necessity is questionable and decide on the course of action in consultation with medical officer.
• Takes accountability in considering business and regulatory compliance risks and takes appropriate steps to mitigate the risks.
• Maintains awareness of industry trends on regulatory compliance, emerging threats and technologies in order to understand the risk and better safeguard the company.
• Highlights any potential concerns /risks and proactively shares best risk management practices.

The Person:

• Degree in Nursing or Healthcare related discipline of State Registered Nurse or Medical Assistant with 2-3 years of experience.
• 5 – 8 years of clinical experience preferably with experience in A&E, ICU and OT.
• Working experience in managed healthcare environment would be an asset.
• Good knowledge in current healthcare delivery systems and hospital patient management and billing system would be an advantage.
• Possess initiative, good interpersonal and communication skills.
• Knowledge in medical terminology, contract provisions and MMA coding.
• Good knowledge in current healthcare delivery systems and hospital patient management and billing system.
• Have the right attitude for hard work and able to produce high quality work under pressure.
• High level of integrity, takes accountability of work and good attitude over teamwork.
• Takes initiative to improve current state of things and adaptable to embrace new changes.

Great Eastern Malaysia is committed to Equal Employment Opportunity, and all qualified applicants shall receive a fair and equal consideration for employment.

Entity: Great Eastern Life Malaysia

Employment Type: Permanent