HMO Member Relations Specialist

iCare HMO; Tarlac City; On-site; PHP 240,000 - 360,000; Part time

Job summary

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

The role emphasizes maintaining provider relations, processing LOAs, and coordinating with the Sales and Marketing Division to optimize member benefits and service delivery.

Qualifications

• Graduate with a 4-year college degree; medical allied preferred.
• Experience in insurance/HMO and value-adding services preferred.
• Strong communication, coordination, and negotiation skills.

Responsibilities

• Assist insured members during availments and ensure proper customer service.
• Provide timely responses to member queries, concerns and/or complaints.
• Maintain updated knowledge of regulations, policies, and medical updates affecting services and benefits.
• Assist Provider Management by expanding accredited facilities and managing provider records.
• Oversee LOA issuance, MD scheduling, and utilization management processes.

Skills

Communication

Coordination

Negotiation

Education

4-year college degree (medical allied)

Job description

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

The role emphasizes maintaining provider relations, processing LOAs, and coordinating with the Sales and Marketing Division to optimize member benefits and service delivery.