medical operations manager

2 weeks ago

Pasig, National Capital Region, Philippines Value Care Health Systems, Inc Full time

We are looking for a MEDICAL OPERATIONS MANAGER to join our growing TEAM

The Medical Operations Manager provides, in collaboration with the Medical Director, operational expertise, medical decision support, and direction for the day-to-day activities in the areas of medical management and medical affairs for the company. The Medical Division Manager ensures the provision of high-quality healthcare to ValuCare Members by planning, implementing, controlling, and evaluating healthcare delivery programs and operations as aligned with the overall plans set by the Medical Director. The role will also identify, align, and uphold the standards for quality health care and service excellence.

JOB RESPONSIBILITIES:

  • Assists the Medical Director in maintaining company operations by initiating, coordinating, and enforcing operational, personnel, and corporate medical policies and procedures
  • Acts as a co-lead in dealing with provider groups for all medical practice matters. Ensures the provider's network meets strategic goals
  • Provides medical guidance and interpretation for all utilization management issues (prior authorization, concurrent review, retrospective review, and claims payments) and all quality management department issues
  • Co-chairs Peer Review, Credentialing, and Pharmacy & Therapeutics committees or others as directed
  • Working together with the Medical Director as Liaison to the corporate medical department - identifying short-term and long-range issues to be addressed; providing information and medical recommendations pertinent to deliberations; presenting options and recommending courses of action, especially where medical and legal considerations are involved
  • Ensures all departmental KPIs are within targets
  • Maintains the stability and reputation of the company by complying with all appropriate regulatory requirements
  • Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies
  • Maintains client confidence and protects operations by keeping information confidential
  • Provides support and technical knowledge for any physician education activities

QUALIFICATIONS:

  • Candidate must possess at least a bachelor's Degree in Medicine / Doctor of Medicine or equivalent.
  • 10 years of working experience in a related field is required for this position with an operations background obtained from a corporate setting or equivalent is required for this position.
  • With people management skills
  • Good interpersonal and communication skills.
  • Results-oriented with good leadership skills.

We offer competitive benefits to successful candidates:

  • Leave benefits (15 vacation leaves and 15 sick leaves)
  • Guaranteed HMO on your first day
  • Performance-based bonus (up to 2 months)
  • Profit Sharing
  • Life Insurance Coverage
  • Healthcare benefit coverage for up to 4 dependents
  • Leave Conversion
  • Annual Salary Increase
  • Medicine and Vitamins Allowance
  • Company Sponsored Training
Your application will include the following questions:

What's your expected monthly basic salary?

How many years' experience do you have as an operations manager?

Do you have customer service experience?

How many years of people management experience do you have?

How much notice are you required to give your current employer?

How many years' experience do you have as a Healthcare Professional?

Value Care Health Systems, Inc. was established in June 1997 by a group of doctors. Since its inception in the said year, Value Care Health Systems, Inc. has grown to become one of the leading Health Maintenance Organization (HMO) in the Philippines. From an initial team of 30 employees, the company now employs more than 200 service-oriented personnel to serve its over 300,000 plan holders nationwide. Branch offices have been established in Makati, Cebu, Iloilo and Davao to meet the needs of its ever expanding clients base. Value Care Health Systems, Inc. held as its principle the commitment to provide "HealthCare You Can Count On."

Value Care Health Systems, Inc. was established in June 1997 by a group of doctors. Since its inception in the said year, Value Care Health Systems, Inc. has grown to become one of the leading Health Maintenance Organization (HMO) in the Philippines. From an initial team of 30 employees, the company now employs more than 200 service-oriented personnel to serve its over 300,000 plan holders nationwide. Branch offices have been established in Makati, Cebu, Iloilo and Davao to meet the needs of its ever expanding clients base. Value Care Health Systems, Inc. held as its principle the commitment to provide "HealthCare You Can Count On."

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Perks and benefits

Medical

Education support

Vision

Performance Based Bonus / 15 SL & 15 VL / Retireme

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