network Management senior manager (hmo - licensed medical doctor)M2MJ Human Resources Consulting
Workplace: Makati
Salary: Apply
Work form: Full time
Posting Date: 11/11/2025
Deadline: 13/02/2021
Description
Job Functions:
• Evaluates network to identify areas for network growth.
• Evaluates credentials of potential providers and physicians applying for accreditation.
• Performs ocular inspection of provider facilities.
• Orients newly accredited providers.
• Ensures completion of contract and correct encoding of provider in the company's system.
• Evaluates provider performance for accreditation renewal.
• Generates quarterly utilization reports from the system concerning accredited providers (hospitals / clinics) to be submitted
and utilized by the department for renewal of rates evaluation of hospitals / clinics.
• Ensure seamless service to members by maintaining good provider relations and troubleshooting any provider-related issues.
• Designates Hospital Coordinators or Quality Care Program Coordinators, establish metrics and utilization management
guidelines and continuous performance evaluation.
Job Requirements:
• Must be a licensed Medical Doctor
• At least five years of related work experience in an HMO industry.
Requirements
Minimum education level: Bachelor ́s Degree
Years of experience: 3
Language(s): English
Availability for travel: Yes
Availability for change of residence: Yes
Job Functions:
• Evaluates network to identify areas for network growth.
• Evaluates credentials of potential providers and physicians applying for accreditation.
• Performs ocular inspection of provider facilities.
• Orients newly accredited providers.
• Ensures completion of contract and correct encoding of provider in the company's system.
• Evaluates provider performance for accreditation renewal.
• Generates quarterly utilization reports from the system concerning accredited providers (hospitals / clinics) to be submitted
and utilized by the department for renewal of rates evaluation of hospitals / clinics.
• Ensure seamless service to members by maintaining good provider relations and troubleshooting any provider-related issues.
• Designates Hospital Coordinators or Quality Care Program Coordinators, establish metrics and utilization management
guidelines and continuous performance evaluation.
Job Requirements:
• Must be a licensed Medical Doctor
• At least five years of related work experience in an HMO industry.
Requirements
Minimum education level: Bachelor ́s Degree
Years of experience: 3
Language(s): English
Availability for travel: Yes
Availability for change of residence: Yes
Other Info
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M2MJ Human Resources Consulting
About the company
M2MJ Human Resources Consulting jobs
Makati, National Capital Region · 11 September (updated)
Position network Management senior manager (hmo - licensed medical doctor) recruited by the company M2MJ Human Resources Consulting at Makati, Joboko automatically collects the salary of Apply, finds more jobs on Network Management Senior Manager (HMO - Licensed Medical Doctor) or M2MJ Human Resources Consulting company in the links above
About the company
M2MJ Human Resources Consulting jobs
Makati, National Capital Region · 11 September (updated)