Job Overview

The MPM Manager 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 medical 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.

Key Responsibilities:

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.

Medical Provider Contracting: Negotiations with healthcare providers to secure favorable terms and conditions, ensuring cost-effective care and robust applicable provider revenues.

Medical Provider Relations: Establish and maintain positive relationships with network providers, addressing any concerns or issues promptly and escalating as needed.

Compliance: Ensure Medical 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 Medical 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.

Work effectively with AI, machine learning, data analytics, and cloud-based tools, adhering to high standards of data governance, security, and ethical use.

Key Requirements:

Education: Bachelor’s degree in healthcare administration, Business Administration, or a related field. Master’s degree preferred.

Experience: Minimum of 5-7 years of experience in healthcare network management

Skills:

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

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