Kerja Sepenuh Masa, Deputy Manager Operations di IHH HEALTHCARE SINGAPORE - Maukerja

The Deputy Manager, Operations is responsible for overseeing the end-to-end operational delivery and administration of healthcare and employee benefits programmes, including inpatient pre-authorisation, medical cost containment, appeals and ex gratia assessments, claims operations, payment reporting, SLA governance, client service delivery, and vendor management.

The role provides leadership to the Operations team, ensuring service excellence, operational efficiency, regulatory compliance, and adherence to contractual obligations across strategic client accounts. Acting as the deputy to the Manager, Operations, the incumbent is responsible for driving operational performance, managing stakeholder relationships, supporting business growth initiatives, and ensuring business continuity across the organisation.

Inpatient Pre-Authorisation & Medical Management

• Oversee inpatient pre-authorisation operations to ensure compliance with policy provisions, medical guidelines, client requirements, and service standards.
• Provide guidance on complex medical cases, including admission appropriateness, benefit eligibility, treatment necessity, and cost management.
• Collaborate with clinical teams, hospitals, healthcare providers, and specialists to facilitate timely medical decisions and service delivery.
• Monitor operational performance, turnaround times, and service levels, implementing corrective actions where required.

Medical Cost Containment & Case Management

• Lead medical cost containment initiatives to optimise healthcare expenditure while maintaining quality of care.
• Engage providers and stakeholders to manage treatment costs and promote cost-effective treatment options.
• Analyse utilisation trends, claims experience, and medical spend to identify opportunities for cost savings and process improvements.
• Support the achievement of cost management objectives across client portfolios.

Payment Reporting & Financial Administration

• Oversee payment administration processes, including claims payment validation, reconciliation, payment reporting, and management of outstanding items.
• Review and approve periodic payment reports to ensure accuracy, completeness, and timely submission to clients and internal stakeholders.
• Manage the resolution of payment-related discrepancies and escalations in collaboration with Finance, providers, and relevant stakeholders.
• Ensure adherence to financial controls, audit requirements, and reporting governance standards.

Appeals & Ex Gratia Administration

• Oversee the assessment and review of appeals, exceptional cases, and ex gratia requests, ensuring consistency and alignment with business and client objectives. Provide recommendations and operational guidance on complex or high-value cases requiring management intervention.
• Ensure appropriate documentation, governance, and communication of case outcomes to relevant stakeholders.
• Monitor appeal trends and recurring issues, implementing corrective measures and process enhancements where necessary.

Client Portfolio & Stakeholder Management

• Manage the day-to-day operational delivery for assigned strategic client accounts, ensuring adherence to contractual obligations, service levels, and client expectations.
• Act as the key operational contact and escalation point for clients, insurers, healthcare providers, and internal stakeholders.
• Lead operational reviews, service reporting, governance meetings, and client engagements to drive service excellence and client satisfaction.
• Support client onboarding, benefit changes, implementation activities, and operational transition projects.

Operations Governance & Service Delivery

• Lead SLA governance, operational performance monitoring, and service quality management across the operations function.
• Drive cross-functional collaboration to ensure effective and seamless delivery of operational services.
• Identify, implement, and monitor process improvement initiatives, workflow enhancements, and automation opportunities.
• Ensure compliance with organisational policies, regulatory requirements, client contractual obligations, and operational procedures.

Leadership & People Management

• Lead, mentor, and develop the Operations team, fostering a high-performance, customer-focused, and collaborative culture.
• Manage manpower planning, resource allocation, workload balancing, and capability development within the team.
• Lead operational projects, transformation initiatives, and strategic assignments as directed by senior management.
• Act as deputy to the Manager, Operations, providing management coverage, operational leadership, and decision-making support as required.

Requirements:

• Degree in Business, Healthcare Administration, Life Sciences, Insurance, or related disciplines.
• Minimum 6 to 8 years of experience in healthcare administration, employee benefits, insurance, TPA operations, medical claims, pre-authorisation, or related operational functions.
• Experience handling inpatient claims, pre-authorisation processes, appeals, and provider management would be advantageous.
• Strong analytical and problem-solving abilities with sound judgement in managing complex operational cases.
• Excellent stakeholder management and communication skills.
• Ability to manage multiple priorities and work effectively in a fast-paced environment. Proficient in Microsoft Office applications and operational reporting.