Elite Program

Job Description

Manage members’ experience with the relevant operational functions to ensure that services are delivered to the members end to end in every touch point of their journey on a timely manner.
Proactively propose and facilitate Tebtom and all other core healthcare services to the members to ensure that they will receive an appropriate care customized to their current medical needs.
Serve as the main point of contact in providing timely information to the members about Bupa services i.e. pre-authorization, reimbursement claim, Tebtom, hospital delegate services, etc.
Collaborate with cross functional service leaders to customize healthcare services according to the healthcare needs of the targeted population.
Constantly striving in providing excellent service by collecting post-service feedbacks through online questionnaire to assess the quality of service provided to the members.
Provide accurate and useful information to the members and their families on medical information or specific Bupa services.
As necessary direct the members to the recommended doctors and/or alternative providers to ensure that they will be receiving a high level of quality in medical services.
Assess the medical need of the members and refer her to appropriate department i.e. HCS for corresponding medical coaching intervention as required.
Support the understanding of customer and consumer segmentation to offer breakthrough Healthcare services
Support the implementation and segmented serving of our core healthcare services
Report & lead consistently the reporting of KPIs updates for each service offering with data analytics team of the departments
Lead the development and maintenance of Personal Coordinated Care (PCC) dashboard to monitor, review and report progress of KPIs against targets in a consistent manner
Prepare, manage and conduct presentations and business updates to key leaders within the organization
Provide monthly feedback report on the progress of PCC program as part of updates in overall Retention report
Analyse the top recurring issues or service failures which members are facing in the critical touch point along the customer experience journey, and with all stakeholders identify solid actions to eliminate or at least reduce the problems at the minimum level
Monitor and review the progress of Kaizen projects implementation in a timely and consistent manner using a structured action plan and tracker
Ensure risk identification, escalation and mitigation of risks in a timely manner to identify and resolve any impact on project outcome or agreed timelines during project delivery

Skills

Fully operational in handling cases on Reimbursement claims, Pre-authorization approval, commercial approval requests, Membership and benefits coverage
Working knowledge in HCO/Tebtom, International and POC services
Highly customer-focused and strong service orientation providing superior services to Bupa members
Excellent verbal and written communication skills, with the ability to convey issues in a clear, concise and effective manner
Flexible to receive inbound calls and make outbound calls from/to the members and during weekend, holidays and outside working hours
Preferably having healthcare background

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