Head of Provider Management

Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed Head of Provider Management PT. Prudential Life Assurance Indonesia Hospital Provider and value add service Head, leading the horizontal expansion of provider network and vertically deepened the relationship to identify value add services to bring value to the organization and the customer Principle Duties & Responsibilities: Establishment and development of PRUhospital network aligned with the company’s strategic objectives

• Acquire and develop partnership with clinics/hospital providers as aligned with PLA medical network business planning and objectives
• Liaise with clinics/hospital providers to establish, finalize or renew official partnership agreement, discussion on SLA, and conducting negotiation with clinics/hospital providers in terms of hospital costs (room and board, medications) to support PLA medical network business

Settlement of Claims Inquiry and Complaints

• Settle inquiries and complaint from internal and external within the agreed SOP/guideline and agreed SLA
• Pursue a win-win solution with proper escalation/approval process
• Manage reporting including productivity, error rates, trends

Setting up new Medical Officer Team

• Propose a draft of Medical Officer Team role & responsibility to be rolled out on the agreed timeline

Perform claims control

• Create guidelines for overall claims control internal and TPA, inclusive case management and hospital management
• Get approval from the necessary committee an embed in the TPA contracts
• Conduct close monitoring, create alerts/flags and continuously improve from time to time
• Meet the expectation of reduction of claims cost as per the agree KPI

Contribute to the continuous improvement within the Claims department Job Specification:

• Bachelor-Degree in Medical Doctor
• Minimum 8 years in relevant experience as Medical Doctor or Life Insurance
• Has a valid registration/Surat Tanda Registrasi (STR) and license/Surat Ijin Praktek (SIP)
• Graduated from a reputable medical faculty
• Pleasant personality
• Willing to travel to visit hospitals

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.