Network Setup & Admin, Analyst

AIA Malaysia; Kuala Lumpur; On-site; MYR 60,000 - 100,000; Full time

Job summary

AIA Malaysia is recruiting for a Network & Provider Relations role to manage hospital panel enrollment, credentialing reviews, and daily liaison between panel providers and AIA Health Services.

You will support claims operations, monitor SLAs, and assist with contracting, business development, and renewals to optimize provider partnerships. A health or life sciences background is preferred, with strong communication and travel willingness.

Qualifications

• Degree or diploma in health-related field with understanding of healthcare systems.
• Experience or knowledge in healthcare management is preferred.
• Excellent communication and analytical skills required.

Responsibilities

• Network Management: manage hospital panel, credentialing reviews and site visits.
• Provider Engagement: gather feedback from providers for mutual improvement.
• Contracting: support provider contracts and renewals for cost improvements and value.
• Relationship Management: track complaints and ensure smooth operations with AIA Health Services.

Skills

Verbal communication

Written communication

Problem solving

People management

Analytical skills

Travel willingness

Basic computer skills

Education

Degree/Diploma in Health or Life Sciences, Allied Health or relevant disciplines

Tools

MS Office

Job description

At AIA we’ve started an exciting movement to create a healthier, more sustainable future for everyone.

It’s about finding new ways to not only better people's lives, but to better the communities and environments we live in. Encompassing our ambition of helping a billion people live Healthier, Longer, Better Lives by 2030.

And to get there, we need ambitious people who believe in playing an important part in shaping that future. People seeking unmatched career and personal growth opportunities, who are driven to work with, and learn from some of the most inspiring and supportive leaders in the business.

Position Objective:

• To manage (administration related matters) panel of healthcare providers that provides medical services with cashless facility to covered members and policyholders of AIA health insurance policies.
• To support claims operations and act as intermediary for operational matters between panel providers and AIA Health Services.
• Responsible for maintaining providers system set-up, updating and prompt communication for smooth operation between providers & AIA

Roles and Responsibilities:

1. Network Management

Hospital Panel-ship;

• To provide the relevant assessment study on new panel provider applicant and provide recommendations based on credentialing guidelines and requirements.
• To support the process of deliberation by the Hospital Specialist Review Committee which includes documentation and site visits.

Provider Engagement;

• To provide and receive feedback from providers for mutual improvement.

Contracting;

• To support the negotiation of provider contract to gain strong commercial improvements and delivery of major cost savings.
• To be ensure necessary contracts are renewed before expiry, i.e. package pricing contracts and to continuously follow up to ensure contracts are closed within a reasonable time period.

Relationship Management/Communication

• To oversee the handling of complaints from internal and external clients on services related issues by panel providers especially issues related to claims and GL TATs & SLAs.
• To oversee and track swift resolution of claims and GL issues related to internal AHS processes thru active operations meeting and interventions.
• To conduct provider training sessions and proactively communicate with panel providers on new procedures and/or urgent updates to daily operational requirements of AHS

2. Business Development

• To coordinate business events with providers including meetings, official openings, launches, etc.
• To develop and disseminate marketing materials related to packages and Platinum provider with assistance from Provider Business Associates.
• To develop and bridge the relationship between Agency with package and Platinum providers.
• To follow up and close the Addendums for package pricing and terms renegotiations with providers.

3. Alliance Management

• To drive steerage to Platinum and package pricing partners
• To proactively manage the allocation and promotion of health events to preferred or package partners.
• Degree/Diploma in Health or Life Sciences, Allied Health or relevant disciplines
• Working experience in healthcare or managed care or insurance industry.
• Knowledge in healthcare management, experience in nursing and medical advancement.
• Good verbal and written communication skills, problem solving skills, able to manage people, fundamental knowledge in accounting principles, good analytical skills, proficiency in basic computer operating software like MS Office, willing to travel for job assignments.