AVP Operation (Health Insurance) - Halodoc ID｜Meet.jobs

Job Description:

• Provide the technical oversight leadership to ensure that day to day operation and operation support including but not limited to health insurance and membership and policy management, case management, claims management processes, reporting, business analyst for TPA, product and/or new feature implementation are handled in accordance with established processes and procedures.
• Improve the operational systems, processes, and policies in support of the organization's mission specifically, support better case management, claim management, policy and membership administration, reporting management, product and/new feature implementation, business process, and organizational planning.
• Establishing target, KPI, and develop standard operating procedures for policy and membership administration, case management, claim processing, project support management, business, and system analyst, healthcare provider management, and reporting.
• Initiates and directs the necessary action to develop and maintain the provider portal systems(s), customer portal system(s), health insurance policy benefit system(S), claims processing system(s), and customer inquiry system(s) to allow for the processing of all claims and inquiries in a systematic manner. 
• Participate in and/or coordinate both pre-and post-account claims and customer service installation implementation and transition activities to ensure the company’s ability to service contracts and achieve customer satisfaction. 
• Effectively communicate with customers, potential customers, and vendors to maintain strong work relationships and to enhance the potential for futures business. 
• Develops annual planning and strategy objectives to maximize the effectiveness of the department operations. 
• Developing strategic partnership with all stakeholders in implementations and transitioning of new business, providing detailed knowledge on capabilities and capacity of front-end processes. 
• Works with all areas to promote efficient processes, enhance teamwork and gain an understanding of the entire adjudication process, including the use of new technology to improve workflows.
• Performs other duties or projects as assigned to contribute to the efficiency, effectiveness, and productivity of the division.
• Maintains and motivates a staff of competent personnel to best utilize individual and group capabilities by using performance planning, training, staff meetings, etc.

Requirement:

• Candidate must possess at least a Bachelor's Degree in Business Studies/Administration/Management or equivalent.
• At least 10 Year(s) of working experience in health insurance and/or healthcare TPA with exposure to underwriting, membership administration, claims, customer service, and/or training environment, with a minimum of 5 years experience at the managerial level.
• Excellent knowledge of health insurance policy, underwriting, membership, and policy administration
• Excellent knowledge of all facets of underwriting, policy and membership administration, medical/claims procedures, terminology, payment analysis, claims processing systems and reporting
• Ability to perform in a research, analytical, advisory, and consultative role
• Computer literate
• Strong communication and interpersonal skills.
• Excellent communication in English, both oral and written

 

Operations Business Operations Operations Management

Halodoc is a secure health-tech platform with a mission to simplifying access to healthcare by connecting millions of patients with licensed doctors, insurance, labs, and pharmacies in one simple mobile application. Halodoc’s innovative technology, nimble services, and patient focus enable a host of solutions including 24/7 doctor tele consultation via chat, voice or video; medicine purchase & delivery; lab services at home; and strong customer support.  

Halodoc is the 2018 Forbes Indonesia Choice Award winner and Galen Growth’s 2018 Most Innovative HealthTech Startup in Asia, a testimony to a team of compassionate, innovative, trustworthy and agile people who take ownership of their work in building the most trusted digital healthcare company. 

 

Vision:

To be the most trusted digital healthcare companion.

 

Mission:

Simplifying access to healthcare.

 

Our Core Values:

•Be Compassionate

•Be Innovative

•Be Trustworthy

•Be Agile

•Be a Team player

•Take Ownership

 

Benefits and perks of working with us include:

Compensation: Competitive salaries
Lifestyle: Casual dress code, Flexible hours
Progression: Professional development
Welfare: Health insurance