Careers & Jobs at PT. Prima Sarana Jasa

Provider Relation Manager (Doctor - TPA Insurance)

PT. Prima Sarana Jasa

PT. Prima Sarana Jasa (South Jakarta, Jakarta)

DKI Jakarta, Indonesia

Global Excel in Indonesia (PT Prima Sarana Jasa) is a third-party administrator (TPA) with over 2 decades of experience in the Indonesian healthcare market. As a Global Excel family member, we can support our clients with their growth needs. Global Excel provides payers with a consultative approach to cost-effective, quality care programs through a single partnership. We deliver seamlessly tailored solutions 24/7 through our customer service and medical professionals by providing access to our network of certified healthcare facilities, ensuring highly effective cost containment.

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Job function: Health & Medical professions

Industries: Management and Consultancy Services Healthcare and Medical

About this position

The Provider Relation Manager will be responsible for sourcing and managing provider partnerships, negotiating agreements, monitoring provider performance, and ensuring client satisfaction in the TPA Insurance industry.

Responsibilities

• Source and manage new and existing provider partnerships with hospitals, outpatient clinics, specialist clinics and individual medical professionals and others to support future and existing business of the company in Indonesia and overseas including Corporate and Insurance clients.
• To drive Service Provider agreement negotiation process and obtain signed agreements specifying the services the provider is offering, the terms and conditions of service delivery and its timelines and the credit terms.
• To drive Service Provider discount negotiation and make sure that existing and future clients enjoy best rate and price schedule.
• Proactively identify gaps in the Managed Care Team, source additional Service Providers and provide recommendations related to the Service Provider Network to the Operations Team and other internal stakeholders.
• Work closely with the Sales and Marketing team to support new business development with the knowledge of the existing Service Provider Network and/or in the development of the provider network to meet the growing business needs.
• Represent the company in meetings with clients (internal or external), to discuss Service Provider network presence, services, and trends and to deliver periodic status reports with particular attention is paid to the utilization of providers and discounts generated.
• To monitor Service Providers performance, utilization, and adherence to agreed procedures and timelines and feedback the performance to Operations team and the Service Provider.
• Proactively work with the Service Provider on the improvement of their service delivery.
• To work closely with the Operation team and facilitate on incoming requests related to Service Provider issues, a need to source additional providers, provider education request and the feedback about or from a provider.
• To make sure that the process of the guarantee letter is in place to support case management and SLA’s agreed with clients.

Requirements

• Preferably 5 years working experience as a Provider Relations Manager in TPA or Insurance Industry.
• Degree in Medicine.
• Knowledge about Insurance, especially Health will be an advantage.
• Possess a service-centred mindset.
• Strong written and spoken English and Bahasa Indonesia.

Benefits

Huneety A.I Salary Estimate

5,000,000 - 13,000,000 IDR per month

PT. Prima Sarana Jasa

3 jobs

List of jobs found:

Provider Relation Manager (Doctor - TPA Insurance)

Claim Assessor (English Speaker)

Case Assessor/Claim Analyst (English Speaker)

Provider Relation Manager (Doctor - TPA Insurance)

About this position

Responsibilities

Requirements

Benefits

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About PT. Prima Sarana Jasa