Executive Provider Network Management

PROTECTHEALTH CORPORATION SDN. BHD.; Cyberjaya; On-site; MYR 70,000 - 110,000; Full time

Job summary

ProtectHealth Corporation Sdn Bhd invites applications for the role of Executive, Provider Network Management. You will support day-to-day management, empanelment, credentialing, onboarding, performance monitoring and engagement of the provider network.

The role works with healthcare providers and internal stakeholders to maintain accurate records, ensure compliance, and drive cost-containment and efficiency across the provider network.

Qualifications

• 2–4 years of relevant working experience in healthcare provider management or related field.
• Experience with empanelment, credentialing, onboarding or performance monitoring is preferred.
• Ability to work with healthcare data and reports.
• Strong communication and stakeholder coordination skills.

Responsibilities

• Coordinate provider empanelment, credentialing, onboarding, renewal and other provider lifecycle activities.
• Review provider submissions and supporting documentation against established requirements.
• Maintain accurate and up-to-date provider records, agreements and related documentation.
• Monitor provider performance against established KPIs, SLAs and service requirements.
• Track provider issues, complaints and corrective actions and ensure timely follow-up.
• Handle routine provider enquiries and operational matters and elevate significant issues where required.
• Coordinate provider communications, meetings, briefings and engagement activities.
• Assist in compiling and reviewing provider utilisation, cost and performance information.
• Support healthcare cost-containment and Fraud, Waste & Abuse (FWA) monitoring activities.
• Assist with provider contract administration, compliance reviews and audit-related activities.
• Prepare provider reports, trackers and operational updates.
• Support process improvement, digitalisation and other provider network initiatives.

Skills

Strong communication

Stakeholder coordination

Problem-solving

Attention to detail

Education

Bachelor's Degree

Job description

The Executive, Provider Network Management supports the day-to-day management, coordination and monitoring of ProtectHealth’s healthcare provider network.

The role is responsible for supporting provider empanelment, credentialing, onboarding, performance monitoring and engagement, while ensuring accurate provider documentation, timely follow-up and compliance with established requirements.

The incumbent will work closely with healthcare providers and internal stakeholders to support an efficient, responsive and well-governed provider network.

Key responsibilities

Coordinate provider empanelment, credentialing, onboarding, renewal and other provider lifecycle activities.

Review provider submissions and supporting documentation against established requirements.

Maintain accurate and up-to-date provider records, agreements and related documentation.

Monitor provider performance against established KPIs, SLAs and service requirements.

Track provider issues, complaints and corrective actions and ensure timely follow-up.

Handle routine provider enquiries and operational matters and elevate significant issues where required.

Coordinate provider communications, meetings, briefings and engagement activities.

Assist in compiling and reviewing provider utilisation, cost and performance information.

Support healthcare cost-containment and Fraud, Waste & Abuse (FWA) monitoring activities.

Assist with provider contract administration, compliance reviews and audit-related activities.

Prepare provider reports, trackers and operational updates.

Support process improvement, digitalisation and other provider network initiatives.

What we're looking for

Bachelor’s Degree in Healthcare Management, Medicine, Pharmacy, Nursing, Allied Health, Business Administration, Health Administration or a related discipline.

Minimum 2–4 years of relevant working experience within the healthcare industry, preferably in hospitals, health insurance, TPA, managed care or provider network management.

Relevant experience in provider/panel management, provider relations, healthcare operations, medical administration or healthcare claims is preferred.

Exposure to provider empanelment, credentialing, onboarding or performance monitoring would be advantageous.

Exposure to healthcare cost containment, FWA, provider utilisation or provider performance monitoring would be an added advantage.

Comfortable working with healthcare-related data, reports and provider documentation.

Strong communication, stakeholder coordination, problem-solving and attention-to-detail skills.

Able to independently manage assigned responsibilities and follow through on operational matters.

Unlock job insights

Hirer responsiveness Salary match Number of applicants

Your application will include the following questions:

• Which of the following statements best describes your right to work in Malaysia?
• What's your expected monthly basic salary?
• Which of the following types of qualifications do you have?
• How much notice are you required to give your current employer?

Incorporated on 19 December 2016, ProtectHealth Corporation Sdn Bhd (ProtectHealth) is a wholly-owned subsidiary of ProtectHealth Malaysia, established under the Ministry of Health, Malaysia (MOH).

As a not-for-profit company, ProtectHealth coordinates, administers and manages initiatives related to financing healthcare services as mandated by MOH.

Incorporated on 19 December 2016, ProtectHealth Corporation Sdn Bhd (ProtectHealth) is a wholly-owned subsidiary of ProtectHealth Malaysia, established under the Ministry of Health, Malaysia (MOH).

As a not-for-profit company, ProtectHealth coordinates, administers and manages initiatives related to financing healthcare services as mandated by MOH.