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Job description / Role
Job Purpose:
The Manager - Medical Provider Management will support the development, implementation, and management of medical provider networks. Reporting to the Senior Manager or Head of Department, this role focuses on ensuring the quality, cost-effectiveness, and accessibility of healthcare services provided to members. The Manager will negotiate with providers, maintain provider relationships, and collaborate with various departments to optimize network performance. The incumbent is expected to negotiate strategically with the Medical Providers with an objective to procure Medical Services at an optimized cost and to generate revenue through effective applicable various revenue streams and execution of identified revenue generation strategies. The candidate should be able to factually demonstrate the cost savings and to maintain strong Medical Provider relationships.
What you do:
Responsibilities will include, but are not limited to, the following:
Strategy:
- Support and drive the strategy devised by the MPM Management
- Develop cost savings strategies aligned with financial savings target, this is to be delivered by the team but also individually
- Network Development: Develop and maintain a robust network of healthcare providers, including hospitals, physicians, diagnostics and ancillary services.
- Provider Contracting: Negotiations with healthcare providers to secure favorable terms and conditions, ensuring cost-effective care and robust applicable provider revenues.
- Provider Relations: Establish and maintain positive relationships with network providers, addressing any concerns or issues promptly and escalating as needed.
Compliance:
- Ensure Provider network and contract management comply with all relevant internal and external regulations, local mandates, accreditation standards, and organizational policies. Responsible for compliance of TOM and DTP ' s
- Performance Monitoring: Monitor network performance metrics, including cost, quality, and accessibility/segmentation, and implement improvement initiatives as needed.
- Team Collaboration: Work collaboratively with the MPM team providing support, coaching, assistance and guidance to achieve organizational objectives.
Collaboration:
- Work closely with other departments such as Claims, Business development, CRM, Operations and Finance to support overall organizational goals.
Reporting:
- Prepare and present regular reports on network performance to senior leadership
- Uses judgment, diplomacy and confidentiality with respect to the complete procurement process, ensuring integrity.
- Withholds the reputation of the company, beneficiaries, payers and all other parties involved.
- Responsible to follow the Local & Regional DOAP (Delegation of Authority Policy)
Provider Training material :
- Plan Provider training per requirement and maintain updated training material in alignment with local market practices
Requirements:
- Bachelor ' s degree in healthcare administration, Business Administration, or a related field. Master ' s degree preferred.
- Minimum of 5-7 years of experience in healthcare network management
- Strong negotiation and contract management skills
- Excellent communication and interpersonal skills
- Analytical and problem-solving abilities
- Knowledge of healthcare regulations and accreditation standards
- Proficiency in relevant software and technology tools
- Regional medical industry knowledge
Key Benefits / What we offer:
Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey.
We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance.
55910 | Procurement | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent
Allianz Partners Introduction:
Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.
We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.
We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation.
Join us. Let's care for tomorrow.
About the Company
With over 159,000 employees from 172 nationalities across more than 70 countries, we are one of the world's most trusted insurance and asset management companies. We offer a broad range of products and services in property/casualty insurance, life/health insurance, and asset management. We have our largest operational presence in Europe, and our parent company, Allianz SE, is headquartered in Munich, Germany. From jobs in Actuarial, Business and IT to Inhouse Consulting and Investment Management - your opportunities are endless!
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