Network Management / Medical Services- Manager

DUTIES AND RESPONSIBILITIES

Does ocular inspection of clinics and/or primary hospitals (for the provinces only) applying for Accreditation with PhilCare and recommends which among prospective clinics/hospitals meet the requirements of PhilCare and which will be beneficial for PhilCare members in terms of strategic geographic locations within NCR and CALABARZON and Bataan, Tarlac and Pampanga. Submits a report of the ocular inspection to the Manager-Provider Accreditation and Relations Dept. within 48 hours from date of inspection.Generates quarterly utilization reports from the system concerning accredited providers (hospitals/clinics) to be submitted and utilized by the Provider Accreditation and Relations Dept. for renewal of rates evaluation of hospitals/clinics.May attend interdepartmental meetings within PhilCare if the Manager-Provider Accreditation and Relations Dept. is out on field (during orientation of providers or requested meetings by providers) or in the absence of the Manager-Provider Accreditation and Relations Dept.. Assists the Head/OIC/Senior Manager of PARD in doing provider relation visits to accredited hospitals, clinics or doctors as needed. Responsible for visiting designated Quality of Care Program (QCP) medical coordinators and discussing whether the metrics have been met on a quarterly basis Performs other tasks as may be assigned from time to time

QUALIFICATIONS

Minimum Education: Licensed Doctor of Medicine

Experience Required: At least one year of related work experience in an HMO industry

Competencies

Customer ServiceKnowledge of MS Office applicationsOral & written communication skillsGood people, time management and analytic skills      

Working Environment: Office-based; Travels to the provinces as needed