Senior Manager, Provider Network Management (12 months' contract)

We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.

[12 months' contract]

• Developing and implementing strategies to build and maintain a high-quality provider network and TPAs where needed.
• Negotiating contracts with healthcare providers, including fee schedules and performance metrics.
• Monitoring network performance and provider satisfaction and implementing improvements as needed
• Identify global best practices in provider management for adoption, as appropriate in markets.
• Collaborating with internal teams, such as operations, finance, and quality management to ensure network alignment with organizational goals.
• Analyzing data and trends to identify opportunities for network expansion and optimization.
• Perform analytics on network providers to assess performance metrics and provide insights for LBUs.
• Ensuring compliance with regulatory requirements and accreditation standards related to provider network management.
• Steering a team of LBU network management professional and providing guidance and support to achieve goal.
• Develop framework to evaluate medical service providers and their value delivery, integration and funding model.
• Develop framework/guidelines & support LBUs in conducting agreed fee/discount negotiations with providers on price, volume and outcome.
• Define standards for partnership identification, support LBUs in assessing partners’ ability to deliver appeal and sustainability by conducting clinical due diligence.
• Define standards and support LBUs in enhancing capabilities in pharmaceutical benefits management.
• Closely works with Claims team for feedback to providers and vice-versa to claims team on findings from analytics on provider performance.

• Bachelor’s degree in healthcare administration, business administration or a related field
• Proven experience in network and provider management, healthcare administration with minimum of 7+ years of experience in leading a team
• In-depth knowledge of healthcare regulations, compliance requirements and industry trends
• Excellent communication and negotiation skills, with the ability to build and maintain relationship with providers.
• Proficiency in data analysis and reporting, with the ability to use data to drive network optimization and cost containment strategies.
• Knowledge of healthcare IT systems and network management tools
• Strategic thinking and problem-solving skills, with the ability to develop and implement network strategies to meet business objectives.

We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.