Provider Network Supervisor

2 days ago

Makati City, National Capital Region, Philippines Maxicare Healthcare Corporation Full time
  • Reviews and evaluates application of new providers and physicians based on the submitted documentary requirements
  • Collates data, analyzes and drafts service agreements, presents and discusses with new providers, and with existing providers in cases of renewal or signing of service agreements.
  • Coordinates and processes the submitted documents and signed service agreements of new and existing providers and physicians
  • Conducts ocular visit and inspection in the providers' facilities.
  • Conducts orientation to both providers and physicians.
  • Endorses submitted and signed documents and details for set-up prior announcement to all concerned departments. Ensures that all details are correctly uploaded/updated in the system.
  • Conducts regular visits to Providers. Provider visit is an avenue to do business review, cascading of new or updated guidelines and policies of the company, discussion of service-related issues and concerns, payment reconciliation issues, systems improvement, and provisions of the service agreement
  • Negotiates and discusses with new and existing providers packages, discounts, service agreements, and automation initiatives.
  • Resolves, responds or escalates any concerns raised by providers and physicians in assigned areas through emails or meetings with providers and physicians.
  • Reviews, analyzes and escalates claims and payment concerns/issues to the concerned unit / department.
  • Reviews and monitors resolutions and recommendations from concerned departments, and discusses it with the provider/physician
  • Reviews, analyzes, prepares recommendations on how to manage stale claims and submits to Claims Department
  • Collates, analyzes and prepares data and submits reports to Immediate Heads on the proposed changes and enhancements on the provisions of the service agreement from providers and physicians.
  • Collaborates with Marketing and Sales Departments in providing feedback on incident reports raised by internal clients and members.
  • Reviews and endorses the status of a physician's affiliation and changes on CPT rates of assigned Providers.

  • network supervisor

    6 days ago

    Makati City, National Capital Region, Philippines PHIL-FIRST HUMAN RESOURSE AND SERVICES (FHRS) INC Full time

    Bachelor's degree in Computer Science, Information Technology, or a related field (or equivalent experience) 5+ years of progressive experience in network administration/engineering, with at least 2 years in a supervisory role Strong knowledge of networking technologies (TCP/IP, VLANs, routing, switching, DNS, DHCP, VPN, firewalls) Proficiency in network...

  • Recruitment Supervisor

    2 weeks ago

    Makati City, National Capital Region, Philippines Bahama Realty and Development Corp Full time

    RECRUITMENT SUPERVISORJob Summary:The Recruitment Supervisor is responsible for overseeing the recruitment and staffing functions of the organization. This role ensures that recruitment processes are conducted efficiently and effectively to attract top talent. The Recruitment Supervisor provides guidance to recruitment staff, coordinates with department...

  • Wide Area Network

    2 weeks ago

    Makati City, National Capital Region, Philippines Systemantech Full time

    JOB OBJECTIVES:The Wide Area Network (WAN) Engineer is responsible for the management of the Bank's wide area network infrastructure including, but not limited to IP-VPN (Wired and Wireless) and Internet to support the network infrastructure needs of the Bank while complying to the various policies and procedures including its regulatory bodies. Also assists...

  • Network Engineer

    7 days ago

    Makati City, National Capital Region, Philippines Emapta Full time

    Network Security and Performance for Distributed EnterprisesGreat networks stay invisible until something breaks. This opportunity puts you behind resilient infrastructure that prevents outages through proactive monitoring, secure configurations, and disciplined change control. From VPN access to firewall enforcement, your decisions protect data and...

  • Network Engineer

    4 days ago

    Makati City, National Capital Region, Philippines ProV International PH Full time

    AtProV International Philippines, we're not just another tech company – we're athriving communityofpassionate problem-solvers,visionary creators, andtech trailblazers, united by one goal: to empower businesses withcutting-edge IT solutions. With over350 talented professionalsacross the Philippines and growing fast, we're committed to deliveringexceptional...

  • Expert - Network Operations

    6 days ago

    Makati City, National Capital Region, Philippines Globe Telecom Full time

    At Globe, our goal is to create a wonderful world for our people, business, and nation. By uniting people of passion who believe they can make a difference, we are confident that we can achieve this goal.Job DescriptionAs a Network Resource Center Engineer specializing in Fault/Incident Management, your role is crucial in monitoring, acknowledging, and...

  • Network Solutions Specialist

    4 days ago

    Makati City, National Capital Region, Philippines Smart Communications, Inc. Full time

    FUNCTIONAL DUTIES & RESPONSIBILITIESLeads the design and implementation of scalable, resilient, and cost-efficient network architectures for wireless/mobile, access, and core networks.Develops end-to-end network solutions aligned with business objectives, operational requirements, and regulatory standards.Evaluates and integrates emerging technologies (5G,...

  • Network Security Engineer

    2 weeks ago

    Makati City, National Capital Region, Philippines TIM Engineering Full time

    Job description:A Network and Security Engineer is responsible for the design, implementation, and continuous improvement of the entire infrastructure's security posture — encompassing network systems, servers, endpoints, cloud platforms, and perimeter defenses. This role goes beyond traditional network responsibilities, ensuring that all layers of...

  • Network Security Engineer

    2 weeks ago

    Makati City, National Capital Region, Philippines Total Information Management Corporation Full time

    A Network and Security Engineer is responsible for the design, implementation, and continuous improvement of the entire infrastructure's security posture — encompassing network systems, servers, endpoints, cloud platforms, and perimeter defenses. This role goes beyond traditional network responsibilities, ensuring that all layers of infrastructure are...

  • Network Security Engineer

    2 weeks ago

    Makati City, National Capital Region, Philippines Continent 8 Technologies Full time

    As part of our continued expansion, we are on the lookout for a Network Security Engineer (IC2-G4) to join our growing network operations team based in Manila, Philippines.This position will form part of an expanded global team and will focus on the 24/7 support of our DDoS, WAF and Firewall services designed to protect both our customer's environments and...