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Job Description
- Study the medical network of the market, to classify into various classes with identification of strengths and weaknesses.
- Contract with doctors and medical centers that have proven competence in various & rare recognized specialties.
- Submit monthly reports separately for each provider and collectively for each specialty.
- Ensure the medical services are provided to clients with high quality.
- Continuously develop and upgrade the medical network capacity & quality.
- Deliver, explain and clarify the operating letters to the providers, and ensure the understanding of the providers through formal and periodic letters’ delivery to:
- Medical Network
- Medical audit department
- Hotline
- Customer service.
- Marketing and sales
- Optimize operating costs
- Study, meet the requests and resolve medical, marketing, customer service departments’ complaints.
- Solve any problems / challenges within the medical network.
- Prompt response to price approvals, negotiation of prices, and the addition of those services to contracts.
- Make periodic visits (morning & evening) for the entire medical network.
- Continuous follow-up and response to medical network requests.
- Explain the commission's operating error discounts and making financial settlements.
- Resolve problems of claims and held bills with the medical claims department.
- Follow-up on the following:
- Commitment of the medical network to submit its financial claims to the company on the dates specified and agreed upon according to contract.
- Documentary cycle of claims within the company.
- Coordinate with the finance to issue checks according to the dates agreed upon with the medical network.
- Making price comparisons, studies, analysis and negotiate price increase requests.
- Coordinate and constantly communicate with:
- Management.
- Claims medication unit.
- Refund.
- Hospitals contracting.
- Medical department.
- Other team members.
- Train new team members regarding physicians and specialized medical centers.
- Follow-up and supervise the following:
- The update of the network’s data periodically and the formal report sent to the department coordinator and the follow up with the network.
- The medical network’s data correctness that sent on monthly to the various company's departments.
- The department archiving (contracts, price lists, financial clearances).
- Divide and classify doctors and medical centers
- Prepare minutes of meeting with the agreed upon items, explain and deliver to the medical network at the end of each visit.
- Commitment to settle the entire covenant (financial & contracts) within maximum three working days after returning from the mission.
- Submit monthly work plan with the assigned tasks, classified on weekly format then detailed into daily plan
- Submit a periodic report (weekly, monthly, quarterly, semiannually & annually) with the achievements of the department
Job Requirements
- Previous experience in the same position
- Previous experience in healthcare industry
- Excellent communication skills
- Excellent negotiation skills
- Excellent Selling Skills
- Problem Solving & critical thinking skills
- Previous People management experience is a must
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