Senior Manager, Provider Network Management (12 months' contract)
Prudential Services Asia
Date: 5 days ago
City: Kuala Lumpur
Contract type: Full time

Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. 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]
Role and Responsibilities
[12 months' contract]
Role and Responsibilities
- 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.
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