Healthcare Network Operations Senior Specialist (Chuyên viên Cấp cao Nghiệp vụ Hệ thống CSYT)
Core
Manage and govern the network of empaneled medical providers to ensure compliance, quality, and efficient claims processing within the Direct Billing ecosystem.
Role type
Senior Network Operations Specialist (Healthcare)
Builds
Hospital and clinic network operations, provider onboarding, and claims workflows
Domain
Insurance / Healthcare Network Management
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Provider empaneling, claims processing oversight, performance monitoring, audit execution, process standardization, stakeholder negotiation
Preferred skills
Fraud detection, digital automation initiatives, workflow optimization
Technologies
MS Excel, MS Word, MS PowerPoint
Responsibilities
Execute day-to-day operations of hospital and clinic network within the Direct Billing ecosystem; Monitor provider performance indicators and escalate operational gaps; Support provider review, audit, or site visit activities and follow up on corrective actions; Coordinate with Claims teams to ensure efficient end-to-end claims processing; Contribute to process standardization and workflow optimization initiatives.
Seniority
Senior, hands-on IC
