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 competition is vast, and the benefits being offered by the competitors are tempting.  However, MEDICard has taken the lead in providing innovative and productive ideas that cut down the cost of health maintenance without compromising its quality.

MediCard now boasts of more than half a million members and over 54,000 accredited doctors in over 1,000 hospitals and clinics nationwide. It also operates 16 MediCard free-standing clinics that provide services at par with those offered by hospitals minus the confinement.

MediCard is currently looking for assertive, dynamic and energetic individuals to fill up the following vacancy:

Acts as the Medicard representative to their assigned accredited hospitals. Usual activities include, but is not limited to: gathering pertinent details of a member’s admission; documents the admission as well as all interactions with the patient, doctors, hospital staff, and others related to the admission; submits all required reports; assists the patient before and during admission, and at discharge; implements all cost containment measures applicable to the case; ensures that the correct coverage is given to the member.

DUTIES & RESPONSIBILITIES
• Checks for newly admitted members with the admitting section of each assigned hospital and checks the ER for possible admissions from time to time (if ER visits are allowed by hospital for Field LO)
• Informs the TL of all admitted members and possible admissions if applicable, as well as requests for preapproval received with all the necessary details and discusses the appropriate cost containment measure to be applied to the case
• Field LO visits the member to get the history of present illness and other pertinent information and explains to the admitted members: the benefits and limitations of his/her coverage. Provincial Inhouse LOs on the other hand, accomplishes this through call.
• Liaison Officers shall inform the member of the required documents and discharge process of the said hospital.
• Gathers the necessary information about the member's availment, through patient's charts and through the attending physician or coordinator and monitors the progress of the course in the ward for still admitted patients of their respective hospitals to determine early opportunities for discharge and to ensure that management is medically necessary
• Issues letter of authorization for admitted members at assigned hospital for each covered availment and personally makes the confined member sign the said issued LOA
• Coordinates the applied cost containment measure with the attending physician such as updating progress and recovery of the member to facilitate earlier discharge of the member as part of the LOS management or steerage options and bridge the concerns of the admitted members if any
• Assists admitted members during discharge and offers other services such as but not limited to scheduling of follow ups, home service, pharmacy service, telemed etc.
• Reviews the Itemized bills of the member to check for unusual charges and properly endorses the final coverage upon discharge, payables of the member as well as the disapproved charges to the hospital
• Updates all discharge details in MIMS and attaches all pertinent document in the shared folder with claims upon discharge
• Accomplishes progress notes duly signed by patient daily
• Sends location to Team leader each time he/she transfers from home hospital to the other
• Sends itinerary to TL daily
• Anticipates and addresses customer complaints and concerns in a timely manner and immediately refers to Team Leader as needed
• Perform other task that may be assigned from time to time
** Provincial Inhouse Liaison officer has the same duties and responsibilities but does all the Liaising through call only. Documents such as loa, progress notes are either signed by member electronically and sent to the respective hospitals via email or the hospital staff makes the member sign.

KPIs
1. Timeliness: 95% of LOA/Preapp waiver issued within 24 hours
                   100% discharge details updated in MIMS and shared folder with claims
                   upon discharge
                   100% DCR update daily
                   100% Discharge patient within 1 hour upon completion of all documents
                    needed for discharge
                   100% response to query within 1 hour                        
2. Cost Containment: 100% individual target met, at least 50% successful attempt
3. Accuracy of approval: zero error, 100% completion of NFC/NC or 100% correction of error if any
4. Quality: zero complaints, 100% adherence to SOPs and spiels, 100% complete documentation

COMMUNICATION REQUIREMENTS
Internal / External
·       Internal-to collaborate with other BUs like Claims, PRD, SBD, URG, BCG
·       External-members and providers

MINIMUM QUALIFICATIONS
• Graduate of any bachelor's degree preferably in the Paramedical courses
• If not a graduate of any of the Paramedical courses, willing to work in a Medical related environment and willing to learn Medical terms
• Knowledgeable with office software and spreadsheet
• Able to work comfortably under pressure and can meet tight deadlines
• With excellent record keeping skills, keen attention to details and can adhere to SOPs
• Detail oriented and meticulous, able to multitask
• Excellent communication (oral,written) and good people skills
• Strong problem-solving skills.
• Confident and can liaise with other departments or externally
• Willing to work in head office in Makati or be assigned in Metro Manila, Calabarzon or Province depending on the vacancy
• Willing to accept weekend work, working beyond office hours, work on a shifting schedule, or being on call depending on the needs of the business
• Relevant experience required: at least 1 year experience
 
At MediCard, we believe that diversity and inclusion are essential to fostering innovation, collaboration, and growth. We are committed to creating a workplace where everyone, regardless of gender, race, ethnicity, age, sexual orientation, disability, or any other characteristic, feels valued and empowered to contribute their unique perspectives and talents.

Our inclusive hiring practices ensure that we attract, hire, and retain the best talent from all backgrounds. We strive to provide equal opportunities for all candidates and promote a culture of respect, fairness, and transparency. We are dedicated to continuously improving our processes and policies to eliminate biases and barriers, ensuring that every employee has the support and resources they need to thrive.

MediCard is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
 
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