BMI Companies, part of BMI Financial Group, has nearly five decades of experience providing insurance and solutions for families worldwide. Specializing in high-quality Life Insurance, Health Insurance with global coverage, and Travel Assistance Plans, BMI is committed to innovating insurance products for the international community.
About the Role: The purpose of this position is to structure, develop, and maintain a high-quality network of medical providers specifically in the United States and local regions, ensuring accessibility and efficiency of services for insured members. He/ She will be responsible for building and managing relationships with medical providers, ensuring compliance with regulatory requirements, and supporting the development of a cost-efficient and accessible healthcare network.
- Evaluate the existing network of medical providers and actively search for and recruit new providers.
- Establish and maintain business and operational relationships with hospitals and medical providers.
- Perform timely follow-up with providers regarding the update of legal documents (operating permits, accreditations, legal documents, etc.).
- Coordinate periodic training on authorization processes, operational processes, billing methods, and provider management.
- Negotiate competitive rates that contribute to the management of claims costs.
- Provide follow-up on claims and various requirements from insured members.
- Coordinate payment reconciliations with local offices.
- Structure a network of providers with all its components (air ambulances, license verification, permits, evacuation plans, and negotiating prices when necessary).
- Negotiate additional discounts for high-cost cases in the United States.
- Support the Corporate Medical Network Director on specific projects such as (but not limited to) cancer care, electronic invoicing, and the implementation of PROM (Patient Reported Outcomes).
- Will be responsible for onboarding medical evaluators/providers for new life insurance business in all required countries, as well as maintaining this network.
Qualifications:
- Education: Bachelor’s degree in medical field or health administration
- Registered Nurse Certification a PLUS
- Experience: Minimum 3-5 years’ experience in the life and/or health insurance business, specifically regarding the operation of medical networks for health and life products.
- Knowledge of Medical Provider Networks within the U.S. healthcare system, with a focus on ensuring access and efficiency for insured members.
- Experience with Life EOI (Evidence of Insurability) processes, including exposure to multiple vendors and providers across different regions, ensuring seamless coordination and coverage.
- Negotiation Skills
- Effective Communication Skills
