Executive, Health Operations
AXA
MALAYSIA SELANGOR PETALING JAYA
2 hari yang lepas

Description

  • To provide advice, sound judgement and recommendation on case of admission that surpasses the authority of a Healthcare Operations Senior Officer.
  • To authorise, deny and determine extent of insurer’s liability on case of discharge that surpasses the authority of a Healthcare Operations Senior Officer.
  • To assist and / or provide guidance to Healthcare Operations Senior Officer as and when required
  • To plan and undertake thorough investigation of possible frauds and potential subrogation, to record results of examination or investigation and report to Head of its findings.
  • To identify control weaknesses and implement solutions and controls for future improvements.
  • To execute SOPs, best practises, ISO policies and ensure compliance with policies. This shall include compliance of legislative requirement such as data protection and medical confidentiality.
  • To interact closely with other department providing an understanding of how company functions as a whole. To take up any other tasks as deemed fit or as assigned by Head as and when needed.
  • To oversee after- hours (8pm to 8am) Mediclinic work. This shall include the need for verification of customer and benefits, Issuance of outpatient LG and respond to phone calls.
  • To conduct Quality Assurance / Control on regular / routine basis ensuring efficiency, effectiveness and performance are always achieved and maintained in accordance to SLA set- forth by the clients.
  • To report the status of the quality levels of Healthcare Operations Senior Officer / Healthcare Operations Officer and their competency level and identify the areas requiring enhancement.
  • This shall include proposal to Head for Authority review or suspension.

  • To conduct audits of ISO policy and compliance of standards as and when needed and / or as assigned by Head / Manager.
  • To identify training needs and solve specific training problems, either on a one- to- one basis or in groups.
  • To highlight issues related to Schedule of Benefits with suggestions for improving Claims related documents and templates.
  • This shall include designing and maintaining new document templates for daily usage.

  • To record and monitor staff performance in accordance to the KPIs set- forth by the company. To appraise, and provide proposal of staff promotion and / or remuneration to Head / Manager.
  • To record and monitor the trend of minor misconduct issues i.e. late coming and absenteeism. To report to Head / manager for any repetition.
  • To witness a Counselling Session and to provide advice for staff involving in any misconduct.
  • To actively participate in regular team meetings, provide feedback and support to Head / Manager for day to day operational related matters / issues.
  • To work closely with IT for the maintenance and upkeep of systems ensuring day- to- day operation runs smoothly without interruption.
  • To be responsible for the readiness, reliability and stability of systems and systems related operating facilities.
  • To involve in risk management, which includes analysing, identifying, evaluating and estimating the risks which may affect the continuity of business.
  • To work closely with Head / Manager to execute and initiate Business Continuity Plans (BCP).
  • Assist or provide guidance to Healthcare Operations Senior Officer / Healthcare Operations Officer from call escalations as and when required.
  • Respond to e-mails and faxes within agreed client SLA.
  • Respond to phone calls from clients.
  • Qualifications

  • Minimum qualification : Degreein relevant field.
  • Minimum experience : 5 years in the Healthcare Operations
  • Leadership exposure withsimilar capacity is a MUST.
  • Good level of Communication
  • A collaborative and flexiblestyle, with a strong service mentality.
  • Technical / FunctionalKnowledge, Skills and Abilities

  • Computing
  • Critical Thinking
  • Logical Thinking
  • Mentoring
  • Other Role SpecificCompetencies

  • Good communication skills inEnglish, Bahasa Malay.
  • Ability to multi-task and workin a fast paced environment.
  • Possess good general knowledge and the abilityto handle stress and work with minimal supervision.
  • What We Offer

    By joining AXA Partners, you will work in a responsible company, which offers a real culture of expertise & diversity. Our focus is on accelerating the development of everyone’s skills, whilst offering attractive and competitive compensation and opportunities for professional development and growth.

    Additionally, at AXA, we work to make a real difference to people - when amazing things happen and when we create opportunities for a better life, the feeling of pride is extraordinary.

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