Description:
Reporting to the Head of Medical Provider Services, the Senior Manager Provider Services will be responsible for leading the implementation of our out of hospital healthcare provider relationship strategy to improve our customers health care experience, enable delivery of best practice care and build strong collaborative relationships with non-hospital healthcare providers to enhance our customer value propositions.
The role will oversee the end-to-end management of our 3rd party service partners, medical consultants, and pharmaceutical companies. Responsibilities will include contract negotiations, ongoing relationship management and monitoring of the provision of quality, appropriate and innovative services to ILH members.
The primary focus of this role is to ensure that the valuable, accredited and innovative services are available to the ILH members and crucially at an optimum rate to ILH. The rates agreed with our medical professionals and service providers are a fundamental pillar that determines the profitability of the ILH and the quality of services offered to our insured members.
The successful candidate will have a strong commercial focus / good business and financial acumen, experience in negotiations and will be able to demonstrate an ability to work on their own initiative.
Key Accountabilities
- Implement an annual and medium-term negotiation strategy for medical consultants and 3rd party suppliers, ensuring a positive outcome for ILH and value for ILH customers.
- Oversee the negotiation and management of contracts and agreements with medical consultants and 3rd party service providers that supports a cost effective and quality driven agenda on behalf of ILH and our members.
- Use financial modelling techniques to assess, review and to implement change within our annual schedule of medical professional fees that will deliver business benefits.
- Develop a deep understanding consultant activity, claims patterns and associated outcomes, and be able to work with the relevant senior stakeholders to help deliver on the overall business strategy.
- Identify and bring on board potential strategic partners that can positively impact our claims spend and align with the overall business strategy.
- Implement a plan of action that will allow for internal changes to processes and product offerings as a result of changes in the market, specifically as Slaintecare evolves which will directly impact the medical consultant area.
- Develop and monitor budget models for 3rd party providers, that are flexible and can respond to any changes in our business.
- Identify and drive strategic opportunities with our 3rd party providers to improve our business performance and our offering to our members.
- Manage effective communications with key pharmaceutical companies and the NCPE to capture all newly approved drugs and share intel that will help inform ILH pricing assumptions.
- Manage a team of three within the Medical Services team who will support in all areas including implementation of the ILH schedule of medical professional fees and 3rd party contract negotiation and governance.
Desired Knowledge / Experience / Skill
- A relevant specialist third level qualification
- Significant financial experience, with at least 5 years or more in a senior role, preferably in a Private Hospital or Private Medical Insurer.
- Have a strong commercial focus and excellent business acumen.
- Have experience in analysing complex financial information and reports to provide accurate financial recommendations and enable strong negotiations.
- A proven track record in establishing a rapport and trust that facilitates an open dialogue that will ultimately lead to more efficient and transparent negotiation process.
- Ability to negotiate in a fast moving and pressure situation where the counterparty will be senior executives at CEO level.
- Strong understanding of the health industry both domestic and internationally