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Careers

Be part of us and create a healthier nation.

Join our ProtectHealth team, where we see care not as just a service, but the beneficial for each community that we serve. ProtectHealth offers a dynamic work environment, great opportunities for professional development, healthy working environment and competitive pay and benefits package.

We are committed to reached out and served our beneficiaries with our community and developed a good benefit package for relevant target group to provide right healthcare services.

Available Vacancies

Role Description

  • Frontline or Tier 1 inbound & outbound customers for call enquiries, requests, feedbacks, complaints for both voice and non-voice.

Responsibilities

  1. Attending to enquiries/complaints over the telephone, e-mails or other communications platform on products and services.
  2. Attending to enquiries and complaints in an effective & timely manner
  3. To achieve key performance indicators at all times
  4. Comply and conform to company guidelines and standard operating procedures.
  5. To drive individual performance in achieving KPI & targets
    • Service Level Agreement (SLA)
    • Quality
    • Resolution Rate
    • Productivity Rate
  6. Any other tasks that are assigned from time to time which is related to Customer Relationship Management

Role Description

  • The Claims Executive is responsible for the supporting and coordination of claims management and operations activities.

Responsibilities

  1. Support the day-to-day operations of the Operations Department in order to achieve set Turn-around-Time for all defined processes whilst ensuring the quality of claim processing, e.g. registration, provision, adjudication, approval and settlement.
  2. Assist to develop comprehensive medical care and health care business claims rules.
  3. Assist to develop, documenting and updating policies, procedures and workflow of the department.
  4. Provide accurate, reliable and timely financial and statistical reporting of operations including claims, recovery, receivables and provisions.
  5. Liaise with Customer Relationship Management and other related departments on customer complaints and other programs designed to delight customers.
  6. Conduct analysis, prepare periodic reports and presentations when required
  7. Resolves medical & non-medical claims by approving or denying documentation, calculating benefits due, initiating payment and/or composing a denial letter
  8. Any other tasks that may be assigned from time to time-related to claims management roles and functions.

Requirements

  1. A Bachelor’s degree preferably in medical, pharmacy, biotech or any health-related field.
  2. Working experience in SPIKPA / Medical or Healthcare Sector will be an added advantage.
  3. Preferably experience involve in system enhancement and product development.
  4. Excellent written and verbal communication skills.
  5. Computer literate and proficient in Microsoft Office. Candidates must be willing to learn new computer systems and skill as necessary.
  6. Willingness to work creatively and collaboratively in an interdisciplinary environment
  7. Organised and self-motivated
  8. Ability to manage multiple tasks and meet demands of a fast-paced environment with changing priorities.
  9. Preferably Takaful background candidates

Responsibilities

  1. Manage the CEO’s electronic email, assessing priority of appointments and reallocation as necessary.
  2. Perform accurate research and analysis whenever necessary as per instruction.
  3. Coordinate arrangements, meetings and/or conferences as assigned and ensure that CEO is well prepared for the meetings or agendas.
  4. Preparing and disseminating correspondence, memos and forms accordingly.
  5. Compile, proofread and revise drafts of documents and reports.
  6. Maintain CEO’s office systems, including data management to ensure information is organized and easily accessible.
  7. Organizing and maintaining an efficient electronic and paper records filing system in line with the company requirements as well as reviewing the documentation as needed.
  8. Prepare reports, presentations and correspondence accurately and swiftly.
  9. Maintain records of CEO’s contacts, answer and screen telephone calls, and respond to emails, messages and other correspondence.
  10. Preparing agendas, pre-meeting briefings as well as produce documents, briefing papers, reports and presentations for the CEO.
  11. Maintains stakeholder’s confidence and protects operations by keeping information confidential.
  12. Involving and assisting in managing the day-to-day operations of the office by supporting the administrative works given.
  13. Any other duties as may reasonably be required by the CEO and supporting any ad-hoc tasks when required.
  14. Professionally greet and receive guests and clients.
  15. Ensure efficient and effective administrative information and assistance.

Requirements

  1. Diploma or degree or equivalent in business admin or relevant field.
  2. Experienced as Personal Assistant or Secretary at senior management level for minimum of 3 years’ relevant work experience.
  3. Excellent IT skills including Microsoft Office and up-to-date with advancements in office applications and systems.
  4. Excellent written and verbal communication skills.
  5. Exceptional interpersonal and communication skills, to enable professional interaction with a wide range of contacts, both internal and external.
  6. Ability to multi-task and manage time effectively.
  7. Good organizational skills, keen attention to detail and aptitude for problem solving.
  8. Able to work independently with little supervision.
  9. A flexible, pro-active approach to work including the ability to prioritise and re-prioritise.
  10. Ability to deal with sensitive information with discretion and to maintain confidentiality

Role Description

  • Provider Payment Mechanisms & Provider Management is responsible for identification of most effective payment methods depending on the target population and benefit package coverage of the target population. It is also responsible for identifying and evaluating opportunities, negotiating optimal provider payment and reimbursement rates, drafting contracts for an assigned provider or provider network, and providing oversight of the contract management process to ensure patient access to the highest quality, cost-effective and responsive healthcare services, in accordance with applicable regulations and the Company’s policies, practices and procedures. 

Responsibilities

  1. Support the department to identify, design and develop a suitable provider payment mechanism (PPM) that promotes cost-effectiveness and ensures excellent quality of healthcare delivery.
  2. Work closely with Legal to design and develop provider contract standards consistent with the Company’s objectives and policies as well as relevant regulatory requirements.
  3. Ensure all contracting is done inline in compliance with relevant policies, standards, guidelines, and operating procedures.
  4. Maintaining the legal interaction with the provider(s)/supplier(s) that the company will deal with.
  5. Working in collaboration with the Strategic Purchasing Department (SPD) to develop the contracting priorities.
  6. Conduct contract strategy meetings in collaboration with SPD to identify issues and provider requirements, facilitate pricing discussions and obtain senior management input on timelines and deliverables.
  7. Ensure compliance with established policies and procedures, regulatory requirements, and mandatory training requirements to enable efficient PPM implementation.
  8. Assist to develop supplier(s)/provider(s) agreements/contracts by working with cross-functional stakeholders and suppliers to reach an agreement on contract terms and conditions.
  9. Assist in establishing short-term and long-term planning and budget development of the company to support strategic business goals.
  10. Support the developing processes and procedures to facilitate claims services.
  11. Handling complaints/issues regarding providers and working closely with Quality Assurance Department.
  12. Developing/ negotiating/ monitoring healthcare service provider’s agreements.
  13. Partner with other relevant departments to conduct analyses and market trends in order to identify, develop, and implement competitive PPM and reimbursements as well as to develop contracts.
  14. Continuously improve productivity and efficiency of processes throughout the operational organization.
  15. Develop forecasts for future demand and institute appropriate intervention pertaining to PPM & PM in a timely manner based on data evidence.
  16. Negotiate provider contracts to support penetration relative to Company’s strategic direction, competitive market trends and providers expectations.
  17. Foster and maintain superior provider relationships.
  18. Maintain, and preferably exceed, contracting production and quality standards that emphasize on principles of integrity and compliance.
  19. Demonstrate Company’s Core Competencies and values held within.

Requirements

  1. A Bachelor’s degree preferably in medicine, pharmacy or related field.
  2. Preference with a minimum of 3 years working experience in Takaful / Insurance / TPCA / Healthcare industry.
  3. Willingness to work creatively and collaboratively in an interdisciplinary environment.
  4. Organised and self-motivated.
  5. Ability to manage multiple tasks and meet the demands of a fast-paced environment with changing priorities.

Role Description

  • Accountable in a quality improvement process for an effective and efficient healthcare system and healthcare delivery.

Responsibilities

  1. Support and assist in clinical audit to ensure the treatment follow the latest Clinical Practice Guideline (CPG) provided by Ministry of Health.
  2. To carry out the post-pay audit and medical audit for specific disease to compare the differences of claim, treatment and outcome.
  3. Working together with Standard, Quality and Accreditation Department (SQA) to develop criteria for accreditation of providers.
  4. Developing the visit team that will involve SQA and other relevant departments of the Company.
  5. Identify trigger based on quality and appropriateness of health care services provided and not just financial triggers.
  6. Ensure the claim submission system will include the variable/entry that show how the treatment/management had follow the CPG.
  7. To run of post-pay audit of selected disease/treatment, any outlier claims or random sampling.
  8. Present the finding to the management committee/CEO and the proposal on how to make it better
  9. To ensure the new core system/ claim system of the Company will have the variable/entry
  10. Carry out site visits to monitor/help/educate for better claim and treatment submission can be achieved.

Requirements

  1. A Bachelor’s degree preferably in medicine, pharmacy or audit-related field.
  2. Preference with a minimum of 3 years working experience in the Takaful / Insurance / TPCA / Healthcare industry.
  3. Willingness to work creatively and collaboratively in an interdisciplinary environment.
  4. Organised and self-motivated.
  5. Ability to manage multiple tasks and meet the demands of a fast-paced environment with changing priorities.

Responsibilities

  1. Assist and support in developing the Systems Section under the Digital Technologies Department all activities and initiatives and to ensure it achieves the highest possible standards of excellence in all business activities and objectives.
  2. Assist to establish IT policies and systems to support the implementation of strategies set by upper management
  3. Design, build, and maintain codes and ensure the codes are efficient, reusable, and reliable
  4. Evaluating and ensuring the performance, quality, and responsiveness of the applications and the functionality of Systems
  5. Ability to identify minor/major bugs and to fix them in a timely manner
  6. Assist in maintaining the codes’ quality, organization, and automatization
  7. Perform data manipulation and create a report based on requirements and predefined standard
  8. Assist to manage all policy, governance and ensure quality control for all applications which include implementing and managing security or integrity and backup procedures
  9. Perform technical support and training to the external and internal users for the new and current systems
  10. Documents complex procedures and troubleshooting procedures related to systems/networks software and hardware.
  11. Keeping up to date with new technology
  12. Support and assist the department and section heads to perform other responsibilities related to Digital Technologies Department as and when required by the Management

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