Director, Health Provider Management
Director, Health Provider Management
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Job Description
Director Health Provider Management
The Director of Health Provider Management is responsible for leading the development and management of Manulifes healthcare provider network. This role involves negotiating agreements with healthcare providers ensuring the networks adequacy and fostering positive relationships with providers to guarantee high-quality care for customers all with ultimate goal of claim cost containment.
Position Responsibilities:
Design and execute strategies to establish and sustain a high-caliber provider network and third-party administrators (TPAs) when necessary.
Engage in contract negotiations with healthcare providers focusing on fee structures and performance standards.
Oversee network performance and provider satisfaction making enhancements as required.
Identify and adopt the best practices in provider management for relevant markets.
Work collaboratively with internal departments such as operations finance marketing corporate communication and product team to ensure network alignment with organizational objectives.
Analyze data and trends to identify opportunities for network growth and enhancement.
Conduct analytics on network providers to evaluate performance metrics and deliver insights for relevant business teams.
Ensure adherence to regulatory requirements and accreditation standards in provider network management.
Lead a team of network management professionals offering guidance and support to achieve objectives.
Develop frameworks and guidelines in negotiating fees or discounts with providers based on price volume and outcomes.
Collaborate closely with the Claims team to provide feedback to providers and conversely relay findings from provider performance analytics back to the Claims team.
Required Qualifications:
A bachelors degree in healthcare administration business administration or a related field.
Demonstrated experience in network and provider management or healthcare administration with a minimum of 7 years in a leadership role.
Comprehensive understanding of healthcare regulations compliance requirements and industry trends.
Strong communication and negotiation abilities with a talent for building and maintaining relationships with providers.
Skilled in data analysis and reporting with the capability to leverage data for network optimization and cost containment strategies.
Familiarity with healthcare IT systems and network management tools.
Strategic thinking and problem-solving skills with the ability to develop and execute network strategies that align with business objectives.
When you join our team:
Well empower you to learn and grow the career you want.
Well recognize and support you in a flexible environment where well-being and inclusion are more than just words.
As part of our global team well support you in shaping the future you want to see.
About Manulife and John Hancock
Manulife Financial Corporation is a leading international financial services provider helping people make their decisions easier and lives better. To learn more about us visit is an Equal Opportunity Employer
At Manulife/John Hancock we embrace our diversity. We strive to attract develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment retention advancement and compensation and we administer all of our practices and programs without discrimination on the basis of race ancestry place of origin colour ethnic origin citizenship religion or religious beliefs creed sex (including pregnancy and pregnancy-related conditions) sexual orientation genetic characteristics veteran status gender identity gender expression age marital status family status disability or any other ground protected by applicable law.
It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process contact .
Working Arrangement
Required Experience:
Director
Employment Type
Full-Time
