1. Responds to queries from the accredited providers received through email
2. Provides updates every 3 days to the provider regarding claims status
3. Distributes reconciliation list to PPM Specialists
4. Monitor and ensure daily updating of the PPM tracker
5. Maintains reconciliation records, files, and documents and makes it readily available for future retrieval.
6. Recommend and coordinate with PPM Head in formulating guidelines, policies and system enhancement, process improvement.
7. Evaluates and submit performance evaluation of the team.
8. Perform other tasks/duties to be assigned by the immediate superior from time to time enhancements and process improvements to improve the claims operations.

1. Customer Service
   1.1 Acts as reliever for Member Relations Representatives (MRR) deployed in identified clients.
2. Utilization Management
   2.1. Ensures proper gatekeeping and utilization management through:
3. Determination of validity of the member status, benefit coverage and maximum available limit prior issuance of LOAs through information garnered from the Medical Account System (MAS).
4. Review of cases and checking necessity of availment and need for medical procedure.
5. Coordination of catastrophic cases to superior for case management.
6. Relationship Management
   3.1 Builds and maintains good rapport with iCare’s designated Hospital Care Director (HCD) in the hospital, iCare’s roster of accredited physicians and provider personnel.
   3.2 Assists the Provider Management Division by:
   3.3 Increasing the roster of accredited medical facilities especially physicians.
   3.4. Do on the spot or provisional accreditation of member accessed/requested physicians and/or medical facilities.
   3.5. Updating the records of physicians as the need arises.
   3.6 . Conducting orientation/ re-orientation of Accredited Providers.

1. Ensures timely and accurate adjudication of claims from medical service providers within the authority limits. The task involves:
   1.1 Accurate claims adjudication as per medical guidelines and policies.
   1.2 Accurate claims adjudication as per agreed business Standard Operation
   Procedures within the agreed SLAs.
   1.3 Escalation of claims as per agreed SOP.
   1.4 Review and escalation of medical codes, supporting documents and observations to determine medical appropriateness.
2. Researches and determines medical related claims.
3. Maintains records, files and documentation as appropriate.
4. Adjudicates provides an early payment discount and rebates from accredited hospital and
   ensures non forfeiture of discounts.
5. Processes claims within the set SLAs.
6. Approves claims up to Php4,000.00.
7. Monitors and handles stale claims according to IHC guidelines.
8. Corrects adjudication / entry of audited claims to address audit findings.
9. Prepares AR billing letters to the Members/Company for the non-coverable charges.
10. Sends back claims with incomplete documents to the healthcare providers.
11. Issues Utilization Certificates to the Members/s (if necessary).
12. Reverses all invalid ARs.
13. Prepares Service Request to IST and memo to accounting for some changes in payee name.
14. Assists in telephone inquiries of accredited providers and members.
15. Meet daily quota requirements.
16. Meets 100% productivity / efficiency.
17. Performs other duties assigned by the immediate superior from time to time.

1. Gather and analyze business requirements from stakeholders: Conduct interviews, surveys, and meetings to understand business needs and document requirements.
2. Develop detailed business and functional specifications: Create comprehensive documentation that outlines business processes, system requirements, and functional specifications.
3. Conduct gap analysis and recommend solutions: Identify gaps between current and desired states, and propose actionable solutions to bridge those gaps.
4. Create process models, flowcharts, and diagrams to represent business processes: Use tools like Visio or similar tools to visually map out business processes and workflows, whenever necessary.
5. Collaborate with IT and development teams to ensure solutions meet business needs: Work closely with technical teams to translate business requirements into technical specifications and ensure alignment.
6. Perform user acceptance testing (UAT) and ensure successful implementation of solutions: Develop test plans, coordinate UAT activities, and validate that solutions meet business requirements.
7. Monitor and report on project progress, risks, and issues: Track project milestones, identify potential risks, and provide regular status updates to stakeholders.
8. Provide training and support to end-users: Develop training materials, conduct training sessions, and offer ongoing support to ensure successful adoption of new systems and processes, whenever necessary.
9. Identify and evaluate potential new vendors to meet business needs: Research and assess vendors based on criteria such as cost, quality, and reliability.
10. Coordinate with vendors to ensure timely delivery of products and services: Manage communication and logistics to ensure vendors meet delivery schedules and quality standards.
11. Build and maintain strong relationships with vendors: Foster positive relationships through regular
12. communication, meetings, and feedback.
13. Review and negotiate contracts with vendors to ensure fair and favorable terms: Analyze contract terms, negotiate pricing and service levels, and ensure compliance with company policies.
14. Monitor vendor performance and address any issues or concerns: Track vendor performance metrics, conduct performance reviews, and resolve any issues that arise.
15. Ensure compliance with company policies and industry regulations: Verify that vendors adhere to company policies, legal requirements, and industry standards.
16. Develop implementation plans and timelines: Create detailed plans outlining the steps required to implement or onboard client in the existing HMO systems or processes, includin timelines and resource allocation.
17. Coordinate with cross-functional teams to execute implementation plans: Work with various
18. departments to ensure all aspects of the implementation are covered and executed smoothly.
19. Provide first level of support: Perform or provide first-level, or repeatable, support work based on documentations provided by the main support group and/or first-hand knowledge about the systems and associated rules.

Customer Service

• Ensure that IHC members availing of medical services in accredited medical facilities are assisted accordingly.
• Ensure that members’ queries, concerns and/or complaints are attended to in a timely and appropriate manner prior to elevating this to the Medical Director.
• Keep abreast with current regulations and policies affecting medical services and implementation and provide proper guidance to all concerned.
• Be up to date on medical updates, utilization management, newly onboarded and renewed account benefits.
• Maintain company spiels and lines that will entice members to call them regarding their benefit including medical network inquiries, concerns and LOA issuances.
• Ensure that the member’s coverage and benefits is discussed appropriately and issue the letter of authorization (LOA).
• Assist the member during their availment by checking medical facility charges and professional fees to maximize member’s benefits and to prevent incurrence of excess charges beyond the benefit coverage and advises member on non-covered charges.
• Issue LOAs and assist members for MD scheduling of appointments and other services.
• Distribute service evaluation survey forms and ensure that the targeted confidence level and margin of error is met on a monthly basis.
• Receive comments, suggestions and feedback and collates survey results.

Utilization Management

• Ensure proper gatekeeping and utilization management through:
  • Determination of validity of the member status, benefit coverage and maximum available limit prior issuance of LOAs through information garnered from the Medical Account System (MAS).
  • Review of cases and checking necessity of availment and need for medical procedure.
  • Coordination of catastrophic cases to superior for case management.

Relationship Management

• Assist the Provider Management Division by:
  • Updating the records of physicians in coordination with Provider Accreditation and Relations team as the need arises.
  • Conducting initial claims for reimbursement screening submitted by members and inform members of any lacking documents, if any.
  • Monitor claims and inform members of acceptance/denial and release of checks

1. Ensure the proper monitoring of confinements of iCare members in accredited medical facilities.
2. Ensure that members’ queries, concerns and/or complaints are attended to in a timely and appropriate manner prior to elevating this to the HLO Head.
3. Keep abreast with current regulations and policies affecting medical services and implementation and provide proper guidance to all concerned.
4. Be up to date on medical updates, utilization management, newly onboarded and renewed account benefits.
5. Maintain company spiels and lines that will entice members to approach him/her regarding their benefit including medical network inquiries, concerns and LOA issuances
6. Visit admitted members ensuring to discuss the member’s coverage and benefits and issue the letter of authorization (LOA).
7. Monitor daily the member’s progress chart to know member’s needs and current medical condition.
8. Assist the member during discharge by checking hospital charges and professional fees to maximize member’s benefits and to prevent incurrence of excess charges beyond the benefit coverage and advise member on non-covered charges.
9. Build and maintain good rapport with iCare’s designated Hospital Care Director (HCD) in the hospital, iCare’s roster of accredited physicians and provider personnel.
10. Visit hospital administrators, HCDs and iCare- accredited doctors to act promptly on their concerns (i.e., unpaid claims, distribution of checks, implementation of new hospital policies, etc.).
11. Assist in creating and organizing processes, information acquisition and appropriate agreements to ensure alignment with the company's policies on Health & Safety, Quality Assurance, Marketing & Brand Management, and Risk & Integrity Management.
12. Ensure proper gatekeeping and utilization management through:
    a. Determination of validity of the member status, benefit coverage and maximum available limit prior issuance of LOAs through information garnered from the Medical Account System (MAS).
    b. Review of cases and checking necessity for confinement and need for medical procedure.
    c. Coordination of catastrophic cases to superior for case management.
13. Distribute service evaluation survey forms and ensure that the targeted confidence level and margin of error is met on a monthly basis.
14. Receive comments, suggestions and feedback and collates survey results.
15. Assist the Provider Management Division by:
    a. Increasing the roster of accredited medical facilities especially physicians.
    b. Do on the spot or provisional accreditation of member accessed/requested physicians and/or medical facilities.
    c. Updating the records of physicians as the need arises.
    d. Collecting and/or releasing documents to and from accredited medical facilities.
    e. Coordinating with accredited medical facilities for payment, OR follow-ups or lifting of suspensions.
16. Work with internal and external leaders in areas affecting department operations.
17. Contribute to create processes for Medical Audit and ensure proper application through an established and agreed medical audit exercise.
18. Participate in current process review and development of new and / or revised work processes,
    policies and procedures relating to Utilization Management responsibilities.
19. Submit reports relative to duties and responsibilities.

Validate Agreement Benefit Plans Setup for Corporate Accounts

• Ability to read, analyze and interpret benefit plans and concessions to ensure that our client’s
• plan requirements are properly setup in the core system.
• Develops and executes formal test plans to ensure the delivery of right benefit plans setup.
• Coordinates and communicates the implementation of the new program/module or benefits
• to the BPA staff to ensure the awareness of the additions/changes in the systems.
• Maintains the standard policies, procedures and turn-around-time in updating the renewal
• Agreement to ensure the accuracy in processing and promptness in reviewing the renewal benefit plans.

Review and Approval of Billing Statement

• Generates monthly corporate accounts due for reviews and updates to ensures that all
• renewing and succeeding accounts will be billed and delivered on time.
• Monitors monthly renewing accounts and updates the renewal Agreement upon receiving of
• the conforme and Agreement Benefits Summary to assure accuracy in processing of renewal
• billing quotation.
• Schedules the updates of members including the additions, deletions and changes in the
• members profile and benefit plan to ensure the client’s request are met on time.
• Verifies membership eligibility and benefits package through Agreement Benefits Summary
• before encoding of members to ensure the accuracy in the client database and billings.
• Reviews the client-company endorsement letter for cancellation of membership through
• Agreement Benefits Summary before deletion of members to ensure that no violated contract
• provision.
• Communicates to the client through written communication to ensure that all are properly
• documented.
• Flags billing and creates AR and GL transmittal to ensures the Accounting Department will capture all billings on-time.

Centralized Processing and Validate Issuance of Membership Cards

• Expedites the processing of membership cards immediately after generating the billing and ensuring all members will receive their individual membership cards accurately and timely delivery.
• Develops accurate standard process
• Provides a complete list of processed members, on-hold status and dis-qualified enrollees to the client to ensure that all members are identified accurately.
• Communicates with the Account Management Staff / Agents / Brokers / Client the document or information needed through written communication to assure accuracy in data encoding and/or completeness of requirements.
• Always observe and apply the rule of Data Privacy Act Law.

Membership Fees Accounts Receivables Collections and Reconciliation of Payments Versus Billings

• Maintains the basic accounting principles, practices and procedures to ensures that work is properly completed in a timely and accurate manner.
• Assists in development and implementation of new procedures and features to enhance the workflow of the accounts receivables collections and reconciliations.
• Collaborates with the different division/department in continuously reviewing and monitoring of A/R membership fees with the objective to zero out the balances and excess payment in a timely manner.
• Coordinates with the Collections Specialist to resolves client-billing problems and rescues account receivable delinquency with a sense of urgency.
• Updates listing of Membership Fees Accounts Receivables with the purpose of following-up to client-company to settle any unpaid/balances membership fees.
• Provides Customer Service regarding collection issues, process client-corporate refunds, process and review account adjustments. Resolve client discrepancies and short payments. Responsible for monitoring and maintaining assigned accounts – customer calls, accounts adjustments, small balance write off, customers reconciliations and processing credit memos.
• Generates and send out unpaid/balance membership fees letter to client-company to ensure that all communications are documented.

Computation and Processing of Unused Membership Fees, Return of Premium and Excess Payment (REFUND)

• Identifies payments that need to be refunded, reconcile all billing transactions with excess payment and prepare all required documentation to ensure accurate processing of all transactions.
• Communicates with client-company, when necessary, to resolve overpayment issues.

Monitoring and Reporting

• Monitors the monthly accounts due for renewing and succeeding corporate accounts to ensures that all accounts can able to process in timely manner.
• Monitors documents needed in the processing of the new/renewal accounts from Sales and Marketing Department or to client-corporate to complete the releasing of the membership cards and to ensure client satisfaction.
• Provides letters/emails of follow-up to corporate client such as non-submission of application for corporate membership form, photocopy of marriage/birth certificate to proof the eligibility in hierarchy, proper client endorsement of enrollment of their newly hired employees in the middle contract, refund guidelines and procedure, disapproved enrollment and other related matters to ensures that all communications are properly documented.
• Updates unpaid, balances and excess membership fees to ensure that corporate clients are fully aware of receivables.

Set Goals and Deliver Results

• Creates strategy, goals or plans for the team as appropriate, in alignment with Corporate Ambition (Goals).
• Set annual individual and team performance goals, using the SMART framework.
• Identifies action steps and timeliness needed to reach objectives.
• Communicates plans to staff and delegate work.
• Effectively allocate available resources.
• Tracks progress to ensure completion of work within target deadlines.

Provide Supervision

• Provides administrative leadership in managing people, infrastructure and facilities.
• Oversees workflow and take action to ensure performance (e.g., adjust timelines, solve problems).
• Maintains compliance with Company policies and guidelines, project-based employees obligations and Philippine Labor Code Law.
• Acts as liaison or moderator and know when to seek assistance from other resources in resolving conflicts.
• Supports the work and objectives of Benefit Plan Administration Staff and Customer Service Staff.
• Protects valuable records from being lost, corrupted or stolen.
• Ensures that BPA Staff apply proper procedures and timeliness.

Manage Operations

• Provides administrative leadership in managing people, infrastructure and facilities.
• Administers operational procedures to ensure that the department runs smoothly.
• Completes appropriate budgeting and financial reporting.
• Plans and facilitates effective meetings.
• Implements changes and new systems or programs within the department.
• Engages staff in using best-practice tools and methodology.

Staff Management

• Aligns the right work with the right people; delegates tasks according to people’s strengthsand interests.
• Ensures staff have the skills and resources to get things done. Provides staff with coaching, training, and opportunities for growth to improve their skills.
• Gives staff ongoing, constructive feedback on their performance and progress in light of expectations and goals. Holds timely discussions and performance reviews.
• Lets staff know what is expected of them and holds them accountable. Differentiates between high and low performance. Rewards and recognizes hard work and results. Works to create a strong team. Treats all staff fairly and consistently. Shares accountability when delegating. Involves staff in setting their performance goals.
• Addresses performance issues promptly and corrects poor performance.
• Balances guiding the others’ actions with granting authority for decision-making within set limits. Provides direction when needed without micro-managing.
• Creates and nurtures a performance-based culture that supports efforts to accomplish the organizational mission and strategic objectives.

Evaluate Performance and Develop People

• Conducts performance reviews on a regular basis (e.g., mid-year, annual reviews).
• Delivers ongoing feedback and address performance issues.
• Recognize training needs and ensure that staff gain needed skills.
• Suggests appropriate training opportunities and assignments.
• Collaborates with staff members to create and implement development plans.

Share Information

• Shares needed information with staff and others in a timely manner.
• Provides a regular forum for sharing information within the department (e.g., weekly staff meetings).
• Provides recognition and praise to motivate the department.
• Collaborates and shares information with other groups or departments.

1. Review of agreement benefit summary of corporate accounts & set-up of benefit plans

• Ability to read, analyze and interpret benefit plans and special concessions to ensure that our client’s plan requirements are properly setup within the core system.
• Coordinate with the Team Lead for review & sign-off of the benefit set-up to ensure accurate
  plan set-up in the system.
• Maintain the standard policies, procedures and turn-around-time (TATs) in benefit plan set-up
  for new accounts or update of the benefit plans for the renewal accounts to ensure the
  accuracy in processing and promptness.

2. Member enrollment and generation of billing statement

• Verify the membership eligibility and benefit packages based on Agreement Benefits Summary
  (ABS) before encoding/uploading of members to ensure the accuracy in member enrollment.
• Generate the initial bill for new accounts and ensure that number of members as well as applicable membership fees are as indicated in the ABS. Ensure to release accurate bill and according to agreed TAT.
• Monitors monthly renewing accounts and updates the renewal Agreement upon receipt of the renewal documents (Client’s conforme, ABS and renewal list) to ensure accuracy in processing.
• Generate the renewal bill and ensure to release accurate bill and according to agreed TAT.
• Schedule the updates of members including the additions, deletions and changes in the
  members profile and benefit plan to ensure the Client’s request are met on time.
• Review the Clients’ endorsement letter for cancellation of membership and ensure that it is
  based on the ABS prior to the deletion of members to ensure that there is no violation of
  contract provisions.
• Generate the appropriate bill for member additions and updates and release according to
  agreed TATs.
• Generate the succeeding modal bills and release according to agreed TATs.
• Tag billing and create AR and GL transmittal to ensures the Accounting Department will
  capture all billings on-time.
• Validate the members for enrollment to LGTI.
• Provide the details of members for endorsement of Dental coverage.

3. Centralized processing and validate issuance of membership kit

• Process the membership kits immediately after generating the bill and ensure that all new members will receive their membership cards accurately and on timely delivery.
• Provide a complete list of processed members, on-hold status and dis-qualified enrollees to the Client to ensure that all members are identified accurately.
• Communicate with the Account Executives / Agents / Brokers / Client the document or information needed through written form to assure accuracy in data encoding and/or completeness of requirements.
• Always observe and apply the rule of Data Privacy Act Law.

4. Membership fees accounts receivables collections and reconciliation of payments versus billings

• Maintain the basic accounting principles, practices and procedures to ensures that work is properly completed in a timely and accurate manner.
• Assist/Coordinate with Collections Specialist in reconciliation efforts for receivables/collections of corporate accounts.
• Provide billing details to the Client/Broker as needed/requested to aid in reconciliation of billings/collection.
• Generate and send out unpaid/balance membership fees letter to client-company to ensure that all communications are documented in coordination with Collections Specialist.

5. Computation and processing of unused membership fees, return of premium and excess payment (REFUND)

• Prepare and release the memo and letter to Client for refund of unused membership fees for deleted members, when applicable.
• Identify payments that need to be refunded, reconcile all billing transactions with excess payment and prepare all required documentation to ensure accurate processing of all transactions.
• Communicate with Client to resolve overpayment issues, when necessary.

6. Acknowledge emails especially coming from Sales/AMG and related to accounts that you are specifically handling. If the email was directed to you and you noted that you are not the one that is handling the account, acknowledge the email and include the person handling the account in your email reply for proper handling.

• Always make it a point to answer the call immediately or at least on the 2nd ring.
• When in a face-to-face meeting with someone at the time of call, excuse yourself for a moment
  and ask for permission from the person before you answer the call, get the name, number and
  concern of the caller and inform them that you are attending to another person at the moment
  and that you will call them as soon as you are done. Make sure to return the call.
• Always put your mobile phones on SILENT mode when in a meeting
• As we are mostly working from home and doing online meetings, please upload your profile picture to your account so that people can put a face to the name. Since this is a corporate - provided subscription please use a professional-looking photo.
• Do check your emails first thing at the start of your work as there may be emails that may need
  your immediate attention and/or response.
• Acknowledge emails especially coming from Sales/AMG and related to accounts that you are specifically handling. If the email was directed to you and you noted that you are not the one that is handling the account, acknowledge the email and include the person handling the account in your email reply for proper handling.
• Do make sure that you copy in the original person who sent the email when they refer a case to you. Easier to click the ‘reply all’ button than choosing individual recipients. Do not forget to delete or edit email addresses later if you feel that they should not be among the recipients of your email prior to sending the email.
• Always review your email prior to sending.
• When you have committed to provide a response/report on a specific concern make sure that you will revert to the person on the date/day committed. If information/data cannot be provided on the committed date/day, inform the person accordingly to manage expectations.

1. Acts as co-lead in dealing with provider groups for all medical practice matters. Developing
the best possible working relationships between iCare and its Accredited Providers (Doctors/Hospitals/Clinics/Wellness Partners)

• Ensures provider network meets strategic goals of managing utilization cost while
  providing high quality healthcare to members of iCare.
• Initiate, coordinate, attend meetings that relate to Provider credentialing and iCare’s
  compliance with regulatory requirements, etc.

2. Oversee the clinic management business/portfolio of iCare and ensure coordination with the
company clinics on utilization management initiatives and appropriate care implementation.

3. Provides when needed medical guidance and interpretation for all utilization management
issues (Prior Authorization, Concurrent Review, Retrospective Review)

• Guide the MSC and HLO team with the Pre-approval and concurrent review of cases
  for proper administration of benefits and appropriate care.
• Provide medical guidance in Claims adjudication as necessary.
• Conduct Utilization Review with specific accounts.
• Evaluation of appropriateness of medical care services utilized by the account
  members.

4. Provides when needed medical guidance and interpretation for all utilization management
issues (Prior Authorization, Concurrent Review, Retrospective Review)

• May function as the Lead Healthcare Professional to cover services including but not
  limited to answering medical/clinical inquiries both internal and external.

5. Co-manage the Medical Provider and Services Division, which may include but is not limited to
interviewing and selection, goal setting, and coaching of staff.

6. Participate and lead in appropriate healthcare programs for clients as necessary.

• Creation of preventive health programs in the corporate setting based on the profile of
  the clients.
• Oversee the implementation and management of the Chronic Disease Management
  Program, Sleep Better Program and other health and wellness initiatives of iCare.

1. Design and Develop Solutions

• Participate in requirements gathering, systems analysis and design
  process.
• Analyze business and technical requirements and prepare system
  design specifications.
• Design and code efficient information system solutions.
• Test, debug and correct system errors or faults.

2. Solutions Deployment and Maintenance

• Ensure proper deployment of the application.
• Investigate and address system bugs/ issues in a timely manner.

3. Mentoring

• To provide guidance to junior analyst programmer and colleagues in terms of programming structures, methodologies and techniques.

1. Claims Reimbursement payable processing (target 40/day)

a. To achieve 100% accurate payable processing based on set targets. Payable
processing should be within 1 day turnaround time and zero backlog.
b. Checks and review the supporting documents of all medical claims submitted by
Claims Department.
c. Checks and review claims details transmitted in SAP.

d. Update and edit the lacking information in the system such as cost center, account,
accounting received date and remarks.
e. Check, Review and analyze Journal Entries in SAP.
f. Request Update of Account Creation and Tax update to approver
g. Update the tax tagging in SAP (VAT and Withholding tax).
h. Ensures that the PCL is signed by the authorized signatory and reviewed by the

Medical Auditor

i. Coordinate to claims unit for discrepancy of amount and information.
j. Send email for AP Invoice system approval to the approver.
k. Post Approved AP invoice for payment.
l. Forward AP claims Document to Disbursement Team for Fund Transfer Preparation.

2. Compliance

• 100% accurate computation VAT and Withholding Taxes on all payable processing
  transactions.
• Ensure all payables transactions are fully supported with documents particularly on Billing

3. Customer Service

• Oversee 100% CMT tickets are responded within turnaround time.
• To promptly respond to inquiries through phone, emails and teams chat to employees and service providers.

4. Filing and Organization

• To keep critical documents, such as original copies of claims documents, AP
  Voucher and properly sort and file such documents in an organized manner,
  keeping these documents in a safe and protected area.

5. Others'

• Assist System Process improvement UAT.
• Assist BIR audit submission of supporting documents.
• Assist External and Internal Audit submission of supporting documents.

Renewal of Account

1.1 Reviews health profile and utilization of existing corporate accounts on a semi-annual basis or
annual to check financial risk and recommends intervention when indicated.
1.2 Provide renewal offer to the account two (2) months prior to expiration to give ample time for
negotiation.
1.3 Provides and recommends program enhancement based on the review of the account’s health
profile.
1.4 Coordinates with actuarial regarding pricing and other units of Insular Health Care for the
requirements of the account.

After Sales

2.1 Conducts after sales orientation to ensure that clients understand their benefits and availment
procedure.
2.2 Does account visitation at least three (3) times a year to build rapport and to develop a positive
working relationship with the account.
2.3 Prepares the necessary documents to be routed to different units of Insular Health Care for
proper endorsement of account.
2.4 Serves as a channel between clients and other units of Insular Health Care

Upsell

3.1 Offers enhancement of benefits to the account (i.g. inclusion of dependents coverage, dental,
upgrade of plan)
3.2 Visits and provides proposal for accounts that did not renew within one (1) year from the date
of termination of contract or non-renewal

For Pooling

• Bachelor of Science in Psychology, Human Resources, Industrial Relations or a related field
• Managing employee and labor relations, ensuring compliance with employment legislation and negotiating collective agreements.
• Ensures proper handling of Employee Disciplinary Actions.
• Develops HR policies aligned with hospital objectives and government legislations.

• Bachelor of Science in Business Administration, Marketing, or any sales/business-related courses
• Performance Monitoring and Data Analytics
• Revenue Optimization
• Market Analysis
• Product/Service Development Support