Job Description
ABOUT THE ROLE:
To ensure 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.
KEY RESPONSIBILITIES INCLUDE:
- 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.
- Provide clinical oversight of 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.
- 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.
- Act as the clinical peer lead for panel doctors, including issue resolution and escalations.
- Support the expansion and ongoing development of the doctor panel.
- 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 panel, claims, and utilisation decisions.
- 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 the healthcare system in Singapore.
- 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.
