# Field Liaison Officer **Company**: MediCard Phils., Inc. **Location**: Makati, PH-MPI **Experience**: mid **Job type**: full-time **Category**: Healthcare **Industry**: Healthcare **Apply**: https://aia.wd3.myworkdayjobs.com/en-US/External/job/Makati-PH-MPI/Field-Liaison-Officer_JR-69042?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply **Canonical**: https://yubhub.co/jobs/job_a302ef8a-573 ## Description MediCard Phils., Inc. is one of the country's leading HMO and the only HMO founded and run by Doctors. Since its inception, the concept of service-oriented total health care has been the molding ideal of MediCard. The MediCard Liaison Officer (LO) serves as a Care Partner and Member Advocate, ensuring that members receive timely, medically appropriate, cost-effective, and seamless services within the healthcare ecosystem. **Job Description** **DUTIES & RESPONSIBILITIES** - Healthcare Navigation - Serve as the primary point of contact for members within assigned healthcare facilities. - Guide members in accessing appropriate healthcare services and providers. - Assist members in understanding healthcare benefits, limitations, and available options. - Provide support throughout admission, confinement, treatment, and discharge processes. - Facilitate referrals and coordination of care as needed. - Assist members in navigating complex healthcare situations. **Success Indicators** - High member satisfaction ratings - Improved healthcare navigation experience - Reduced member confusion and escalations - Benefit Implementation and Management - Verify member eligibility and benefit coverage. - Facilitate timely processing of approvals and authorizations. - Explain the coverage, limitations and exclusions, as well as requirements. - Ensure services rendered are within approved benefits and coverage guidelines. - Support efficient claims and documentation processes. - Compliance with authorization turnaround times - Reduced benefit-related complaints - Accurate benefit application - Medical Appropriateness and Care Coordination - Facilitate implementation of MediCard utilization management policies. - Coordinate with healthcare providers regarding covered healthcare services. - Support medically necessary and evidence-based healthcare practices. - Promote treatment in the most appropriate level of care. - Escalate complex medical necessity concerns to designated clinical teams. - Appropriate utilization of healthcare resources - Reduced unnecessary admissions and procedures - Positive provider collaboration - Member Experience Excellence - Deliver compassionate and professional member support. - Practice active listening and empathy during member interactions. - Manage concerns and complaints promptly. - Conduct service recovery activities when necessary. - Ensure every member interaction reflects MediCard's brand promise. - Member Satisfaction Score targets achieved - Increased Net Promoter Score (NPS) - Timely complaint resolution - Provider Relationship Management - Develop positive working relationships with hospital personnel and physicians. - Promote collaborative problem-solving. - Support provider awareness of MediCard processes. - Participate in provider engagement activities. - Gather provider feedback for service improvement. - Positive provider satisfaction ratings - Reduced operational disputes - Improved provider collaboration - Operational and Compliance Excellence - Maintain accurate documentation and records. - Comply with Data Privacy Act requirements and company policies. - Adhere to established service level agreements (SLAs). - Ensure timely reporting and escalation of critical issues. - Participate in quality improvement initiatives. - Audit compliance - Zero major privacy incidents - SLA achievement - Brand Ambassador Responsibilities - Promote MediCard’s brand promise. - Educate members regarding Medicard’s services. - Participate in member education campaigns. - Support brand awareness initiatives within healthcare facilities. - Demonstrate professionalism and service excellence consistently. - Increased awareness of LO role - Positive member and provider perception - High brand compliance scores **MINIMUM QUALIFICATIONS** - Education Required: + Bachelor's Degree in: - Nursing - Medical Technology - Physical Therapy - Pharmacy - Healthcare Administration - Allied Health Sciences - Other healthcare-related courses - Preferred: + Registered Nurse (RN) + Other licensed healthcare professional - Experience Required: + Minimum 2–3 years experience in: - HMO Operations - Hospital Operations - Utilization Management - Case Management - Patient Relations - Healthcare Customer Service - Preferred: + Experience within HMO or managed healthcare environment + Experience in member engagement and care coordination + Experience working with physicians and hospital administrators ## Skills ### Required - Healthcare Navigation - Benefit Implementation and Management - Medical Appropriateness and Care Coordination - Member Experience Excellence - Provider Relationship Management - Operational and Compliance Excellence ### Nice to have - Registered Nurse (RN) - Other licensed healthcare professional - Experience within HMO or managed healthcare environment - Experience in member engagement and care coordination - Experience working with physicians and hospital administrators --- Source: [Apply at aia.wd3.myworkdayjobs.com](https://aia.wd3.myworkdayjobs.com/en-US/External/job/Makati-PH-MPI/Field-Liaison-Officer_JR-69042?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)