Network Development Manager
- To support the Head of Health Risk Management (HRM) in developing, improving and maintaining Bupa Global’s network
- To support research into the relevant approach for the market: direct contracting, hospital network access, cost management through TPA’s or other third party arrangement, and to support delivery of the recommended approach, through to contract compliance
- To manage a portfolio of providers and TPAs / geographical areas delivering strong network position and cost management through direct contracting or relationships with external partners and correspondents
- To liaise with internal stakeholders in a range of departments to ensure that interested parties are consulted and operational capability to support the recommended approach is in place
- Implement, develop and maintain Global`s Health Risk management strategy for the region, ensuring alignment with Bupa Global’s product and proposition development, and sales and service agendas.
- Achieve personal targets and develop pipeline for future activity.
- Research availability and quality of healthcare provision in allocated markets and recommend appropriate purchasing and claims spend management approaches, being direct contracting, network access agreement, cost management arrangements through third parties or product structure and policy application rules.
- Negotiate and oversee negotiations of contracts with providers and / or target partners to enable access to healthcare, delivering financial and commercial advantage through best price and quality care for our customers.
- Build appropriate networks of providers offering comprehensive ranges of inpatient and outpatient services on a cashless basis.
- Act as Healthcare Services lead to ensure successful implementation of operational structures to support delivery of negotiated third party cost management and network access arrangements. In accordance with BG agreed protocols manage providers ensuring delivery of high quality, cost effective customer-focused healthcare to all Bupa Global members consistent with Bupa brand and values.
- Act as point of referral for escalated queries. Conduct ongoing evaluation of relationships through regular meetings and identify opportunities for improvement of service and commercial advantage (value for money).
- In conjunction with other members of HRM review and regularly monitor Bupa Global`s claim spend in allocated markets to ensure that opportunities for additional claims spend management are highlighted.
- Ensure results are incorporated into quarterly provider or partner review processes, and / or annual renewal processes.
- Within allocated markets, support the definition and execution of strategies to extend provider coverage e.g. to build doctors’ networks with agreed discounts and direct settlement, or other outpatient direct settlement arrangements.
- Support the development of speciality networks as required.
The Ideal Candidate
- The job holder should be educated to degree level or a suitable equivalent.
- Strong medical and clinical industry, healthcare practice and knowledge preferred.
- Hospital administration management desirable.
- Previous experience, preferably in international private medical insurance or negotiation.
- Perfect command of English, both written and verbal.
- Strong commercial knowledge of the international health insurance industry.
- Strong insight knowledge of regional hospital industry and its pricing and quality dynamics.
- Excellent commercial negotiation skills, able to deal with high level hospital administrators but also at operational management level.
- Ability to deliver projects on time, budget and within agreed quality.
- Proven track record of achieving targets with a consistent high level of quality.
- Ability to work under pressure in a fast paced environment.
- Ability to influence business areas without having direct management responsibility.