For MedNet Jordan Co. W.L.L.
MedNet Jordan is one of the leading managed care service organizations that caters to healthcare needs. We are currently seeking to hire Senior Officer - Network (on Hybrid working modules basis) with the following tasks and responsibilities:
Your Job
•Maintaining on-going benchmarks of MedNet’s network capabilities in the market according to the network department parameters.
Maintaining MedNet’s network competitiveness by expanding the network access locally as required by business needs.
•Conducting provider credentialing and new provider tariff negotiations. Lead the identification, selection, evaluation, negotiation, contracting and re - contracting process of health care service providers within the established corporate guidelines to ensure that all services are provided cost efficiently in accord to defined quality standards and procedures ensuring optimum protection for business interest.
·Ensure maintenance of information/records of all contracts handled by the network department.
•Build contract’s pricing structure for all health care service providers on the MedNet’s system.
•Preparing price automation through MedNet’s internal price automation modality
•Handling provider requests for tariff revisions to ensure a continued and sustained competitive edge to MedNet.
•Recommend all decisions related to reconciliation with health care service provider to the Network Manager approval.
•Conduct trainings and orientation programs to health care service provider in an efficient manner and as per need.
•Ensure functional relationship between internal departments and the network team and high level of communication and efficient & timely transfer of information takes place during operations.
•Assist in identify opportunities for continuous improvement of the network development, operations management, systems, processes, and practices.
•Follow and implement all Network’s department policies and procedures to ensure that all relevant procedural requirements are fulfilled while delivering a quality, cost-effective service.
•Prepare all required reports in a timely manner for Network Manager’s approval.
Qualifications
Your Profile
·BA in Nursing, Pharmacy, General Medicine, or any related field.
·From 4-7 years of experience in working in TPA/Medical Insurance sector.
·Very good Knowledge of medical terminology.
·Good knowledge in local healthcare services system is a plus.
·Good knowledge and experience in Coding is a plus.