HMO Member Relations Specialist

iCare HMO; Rosario; On-site; PHP 279,000 - 424,000; Full time

Job summary

iCare HMO is seeking an HMO Coordinator / Member Relations Representative to provide administrative support to the Hospital Liaison Officers and Medical Services Division. You will assist insured members during availments and help implement customer service policies to ensure proper utilization management.

The role involves handling member inquiries, issuing LOAs, coordinating MD scheduling, and maintaining strong relationships with hospitals and physicians.

Qualifications

• Graduate of any 4-year college course, medical allied (preferred).
• Good communication, coordination, and negotiation skills.
• BPO experience handling healthcare accounts is an advantage but not required.

Responsibilities

• Provide effective administrative support to Hospital Liaison Officers and Medical Services Division.
• Assist insured members during availment and ensure proper customer service implementation.
• Handle member inquiries, advise on LOAs, and maximize benefit utilization.
• Support utilization management through gatekeeping of member status and coverage.
• Build rapport with hospitals, physicians, and provider personnel; assist accreditation and claims processes.
• Manage surveys, collect feedback, and relay insights to improve service quality.

Skills

Communication

Coordination

Negotiation

Education

Bachelor's degree in any 4-year college course, medical allied (preferred)

Job description

iCare HMO is seeking an HMO Coordinator / Member Relations Representative to provide administrative support to the Hospital Liaison Officers and Medical Services Division. You will assist insured members during availments and help implement customer service policies to ensure proper utilization management.

The role involves handling member inquiries, issuing LOAs, coordinating MD scheduling, and maintaining strong relationships with hospitals and physicians.