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income insurance limited

Panel Management and Clinical Quality (Governance) Manager

Fresher
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  • Posted 13 days ago
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Job Description

This role ensures safe, high-quality, and sustainable care for Income members by governing clinical standards, shaping doctor behaviour, and stewarding a defensible, high-performing provider panel.

This role integrates clinical oversight, doctor behaviour management and quality governance to safeguard standards and reduce variation.

Responsibilities

1 - Lead empanelment and dispanelment of doctors in line with governance and regulatory standards.

  • Segment panel doctors by utilisation patterns, outcomes, and adherence to pathways.
  • Identify high-variance behaviours (over-investigation, over-treatment, repeated exceptions).
  • Implement peer benchmarking, feedback loops, and engagement/education sessions.
  • Lead remediation and manage structured depaneling when necessary.

2 - Provide clinical oversight of the doctor panel credentialing, quality, and performance.

  • Own clinical standards, pathways, and panel participation criteria.
  • Run governance cycles for pathway reviews, clinical policy refresh, and defensibility.
  • Ensure all standards are embedded consistently across.

3 - Oversee compliance monitoring, surveillance activities, and audit readiness.

  • Maintain the integrity, credentialing, and clinical eligibility of the doctor panel.
  • Lead quality of care incident reviews, adverse event assessments, and repeat pattern analysis.
  • Run periodic panel quality audits.
  • Oversee risk flags and escalate where care patterns indicate systemic quality concerns.

4 - Act as the clinical peer lead for panel doctors, including issue resolution and escalations.

5 - Support the expansion and ongoing development of the doctor panel.

6 - Identify and manage clinical, regulatory, and operational risks related to panel management.

  • Provide clinical input into claims rules
  • Partner with Claims to align medical necessity decisions and peer-to-peer reviews.
  • Ensure clinical defensibility of all panels, claims, and utilisation decisions.

7 - Contribute clinical insights to health strategy and panel-related initiatives.

Requirements:

  • Degree in healthcare, life sciences, public health, health administration, or a related discipline, Medical Doctor (MD) or equivalent clinical qualification is preferred.
  • Strong understanding of Singapore's healthcare system.
  • Experience in healthcare provider management, clinical governance, medical affairs, healthcare operations, or a related governance or quality role.
  • Demonstrated experience in managing healthcare compliance, quality assurance, or regulatory-related functions.
  • Proven ability to engage, influence, and build effective working relationships with medical professionals and senior stakeholders.

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Job ID: 144724411