Assistant Manager-Provider Services

Primary Job Responsibility

Responsible for planning, organizing, managing, and controlling their respective departments or units; helps establish objectives and strategies to ensure Corporate and Departmental business plans and Quality objectives are met; and Supervises both Processes and People:

• Process responsibilities include activities such as:
  
  

Work Unit Planning and Implementation

Task Assignment and Scheduling

Problem-solving and Decision-making o Monitoring and Evaluating Results

Escalating issues and/or risks

• People responsibilities include activities such as:
  
  

Developing Team And Individual Skills And Capabilities

Mentoring, Coaching and Job-shadowing

Engaging and Motivating employees

Rating Performance Reviews

Monitoring and providing feedback on day-to-day performance

Counselling and carrying out Disciplinary Activity

Job Description

• Reviews the overall team performance in achieving required Key Result Areas and Key Performance Indicators. Monitors the functions and productivity of IP supervisors and respective team members in rendering service to clients in identified provider and area assignments
• Reviews, approves/disapproves within designated authority limits and overrides letter of authorization issued by Liaison Officers and supervisors to assigned providers during and after confinement
• Collates data from team members for purposes of documentation and review, audit, investigation, and analysis as may be required by the Immediate superior officer (i.e. incident reports, data info gathered from member/doctor/provider/internal)
• Validates, verifies, approves and disapproves daily time records, official or business trips, transportation and other necessary expenses and reimbursements of direct reports
• Collects, collates and analyzes medical documents such as but not limited to, medical certificate, operative record, diagnostic results, clinical abstract and Statement of Account (SOA) data for purposes of reviewing incurred hospital charges with the goal of managing and preventing Fraud, Waste and Abuse (FWA) based on medical criteria set by management and does escalation to Medical whenever necessary
• Handles and manages all types of escalations from designated team or unit prior to hand off and escalation to dependencies, as appropriate & applicable (i.e. Medical, PNM, UEF, Sales, Ops), enables collaboration and ensures action for case resolution and service recovery
• Ensures team compliance to required documentation of confinements such as but not limited to the usage of Salesforce, Genesys and other trackers X Submits accurate, timely, and complete reports (i.e. weekly and monthly LOA actual versus target with analysis, metrics of team performance or any report as deemed necessary)
• Reviews and contributes in updating work processes, policies, procedures, work instructions, workflow, and other documentation as may be required in compliance to existing ISO Certification 9001:2015 standards
• Ensures manning flexibility in cases of absence and/or reassignments and provide resolution
  
  

JOB SPECIFICATIONS

• SKILLS
• EDUCATIONAL REQUIREMENT
  
  

MINIMUM educational level and background required by this POSITION: College Graduate of 4, 5 year-course, preferably: Allied Medical Course

• EXPERIENCE AND TRAINING
  
  

PERIOD OF TIME OR LENGTH of related experience the CANDIDATE must acquire before being assigned to and perform the functions of this job, SATISFACTORILY under NORMAL supervision: Five years - Less than 10 years

• SKILLS REQUIREMENT EXECUTIVES AND MANAGERS
  
  

Broad: INTEGRATION and coordination of activities within a SINGLE management area

• RESPONSIBILITY
• ACCOUNTABILITY – ASSETS, CASH, EQUIPMENT Value or worth of company assets (cash, checks, financial instruments, investments, tools, materials, machinery, equipment, and supplies) this POSITION is accountable for: Small below P500, 000 SPECIFY ASSETS, CASH AND EQUIPMENT DIRECTLY ACCOUNTED FOR: Laptop, Mobile Phone
• ACCOUNTABILITY – RECORDS AND DOCUMENTS Level of CONFIDENTIALITY AND IMPORTANCE of the information, records, reports, and documents prepared, maintained, has access to, and handled by this POSITION Critical, Operational - Only identified and selected individuals are given privilege of knowing contents of any documents; disclosure may have an APPRECIABLE EFFECT on the company RECORDS AND DOCUMENTS DIRECTLY ACCOUNTED FOR: Shared Documents
• NEED FOR SUPERVISION EXTENT of work supervised or managed by the Immediate Superior, whether the job is limited or diversified; quantify range of activities, VARIETY of tasks to be carried out, and the DIVERSITY of the problem to be solved Handles broad assignments, procedures generally; rarely refer to superior except matters of policy
• PEOPLE MANAGEMENT Number of subordinates this POSITION DIRECTLY supervise 6 to 12 subordinates
• CONTACTS – INTERNAL AND EXTERNAL EXTENT the work required in making personal contacts inside and outside of the organization, level of importance of contacts; FREQUENCY they are made; LEVEL OR DEGREE they involve exchanging information, dealing with people, exerting influence, persuading them to take action, etc. Localized, Routine
• EFFORT
• PHYSICAL EFFORT USUAL POSITION at work of this JOB considering energy needed and exerted to satisfactorily perform the job Sitting, talking and/or walking are done in intervals, in combination or alternately
• MENTAL EFFORT AMOUNT OF THINKING to analyze problems; develop and evaluate solutions to given problems Standardized - Job encompasses SEVERAL areas; solution to the problem is READILY APPARENT In differing situations requiring search for solutions within area of learned things
• WORK CONDITIONS
• JOB ENVIRONMENT
  
  

STATE of surrounding and physical conditions under which the JOB must be satisfactorily accomplished Comfortable MOST OF THE TIME in an: Air-conditioned, well-lighted, clean, quiet, conducive room

• SAFETY AND EXPOSURE TO HAZARDS, RISKS, DANGER
  
  

Hazards, risks or danger POSITION is exposed to in job performance, DESPITE safety measures provided Exposure to few moderate numbers of disagreeable elements but only occasionally