Healthcare Network Operations Manager (Quản lý Vận hành Hệ thống CSYT)

Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.

The role requires to strategist across various area of Health area from providers, payers, and hospitals network with strong understanding of the trends, opportunities, and challenges.

To lead and manage the end-to-end operations of the healthcare provider network post-onboarding, ensuring seamless service delivery, robust Direct Billing operations, and strong alignment with claims processes and organizational standards.

Job Description

1. Network Operations Management

• Manage day-to-day operations of hospital and clinic network within the Direct Billing ecosystem
• Ensure providers adhere to claims submission processes, Direct Billing workflows, and service standards
• Act as primary operational focal point for healthcare providers
• Support provider onboarding validation to ensure operational readiness

1. Provider Performance Management

• Coordinate with Claims teams to ensure efficient end-to-end claims processing
• Monitor key metrics: TAT, accuracy, rejection/dispute rates
• Conduct performance reviews and corrective action plans
• Identify root causes of claims discrepancies and inefficiencies

1. Operational Excellence

• Drive process standardization and workflow optimization
• Support digital claims and automation initiatives
• Deliver training and ensure provider alignment with process updates
• Undertake projects / other work and duties allocated by management as and when required.

Job Accountability

• Driving operational excellence across healthcare provider network
• Ensuring efficient Direct Billing and claims execution at provider level
• Strengthening provider performance and governance
• Delivering continuous improvement in service quality, cost, and operational efficiency

Job Requirements

a. Qualification: Degree in Economics, Business Administrative, Business Management, and etc.

b. Experience

• Preferably experience in Operations management, Insurance business and Business Strategic Planning and Health Management will be an advantage.
• Working insurance company or banking at managerial level for at least 5 years.

c. Knowledge, Skills & Attributes

• Insurance/Legal/Health management and project management, Operational management, stakeholder coordination, problem-solving, analytical thinking
• Possess knowledge on Life Insurance claims processing.
• Computer literate and familiar with MS Excel, MS Word & MS PowerPoint.. Self-assured and results oriented

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.