Network Development Manager
- The Provider Contracting Manager is a part of the Health Care Management leadership team.
- A key emphasis of the role will be to ensure high performance work practices, governance, effective performance management principles and KPI’s for the governance of Bupa’s provider network and TPA management. The role will be responsible for the implementation and management of processes and tools to ensure contractual compliance between Bupa Global and all its providers are being adhered to. The role will be the central point of expertise and knowledge for Bupa’s relationship with its providers and will assist in the decision making of working with new and existing providers, local TPA partners and case management.
- A key purpose of this role is to be accountable for the operational management and development of the HCM.
- The Provider Contracting Manager will ensure the team maintain strong relationships with all providers within the Bupa Global network to ensure Bupa Global’s customer and partner propositions are managed to a high standard.
- Drive business-wide governance of Bupa’s provider network to ensure clear standards are delivered and contract compliance is maintained
- Define and maintain the Bupa Global network governance policy to ensure adherence
- Lead the Provider Contracting team, ensuring all team members demonstrate accountability and prioritization to achieve optimal provider / TPA partner relationships and a positive department perception within the business
- Create, implement and manage robust procedures and tools to monitor the Bupa Global network activity including compliance of agreed process, network pricing, clinical protocols and network clinical quality standards
- Manage relationships with providers on a day to day basis and drive high level of provider satisfaction through superior service and proactive activities
- Lead on any issues that require resolution for the network, ensuring internal and external issues and trends are captured and reported to the wider team.
- Responsibility of partner quarterly audits and performance reviews, alongside the team, to ensure continuous compliance of contractual service agreements, report on findings and make recommendations for continuous improvement of services to the network
- Seek regular feedback from the network on Bupa Global performance (both in service and systems) and made recommendations for improvements
- Provide feedback / advice to the HCM function to factor into provider negotiations regarding optimal provider interfaces / processes with Bupa Global
- Ensure the maintenance of accurate network records in all Bupa Global systems (for example SWAN, Facilities Finder, Provider World, etc) to assist in usage and reporting
- Promote ProviderWorld and Facilities Finder providing support to the wider Bupa Global team
- Be a central point of expertise and knowledge on Bupa’s network to provide clarity, consistency and guidance within Bupa Global and as the link with the wider Bupa Group
- Influence and challenge key people from all parts of BGAPAC to ensure appropriate decisions are made that improve the solutions for the network delivered through change programmes
- Familiar with all regulatory requirements that fall within remit and to give due regard to, and comply with as necessary, any requirements placed upon the position or the business by any appropriate regulatory authorities. In particular to give due regard at all times to fair consumer outcomes.
- Liaise with Global clinical to interpret condition and treatment to the rules and regulations of Bupa Global
- Identify opportunities to reduce future claim expense for Bupa Global and to pro-actively provide relevant information to Risk management department
- Proactively negotiate medical costs and/or medical treatment to achieve either reduced cost to the business or most appropriate treatment for member.
- Develop and maintain an up to date and accurate knowledge of appropriate Bupa products, policies and initiatives in order to ensure that all queries are answered accurately.
The Ideal Candidate
- Experience of working in a procurement or contracting role required
- Background in the global health insurance market or medical supplier market, or relevant transferable skills and knowledge from other industries
- Able to establish a performance management culture. Evidence of building talented high performing teams and getting the best out of highly talented people whilst quickly and effectively managing performance issues
- Strong ability to carry out effective coaching and development
- Excellent interpersonal, communication and influencing skills are required with emphasis on achieving results and successful outcomes.
- Exposure to project work including demonstrating successful process improvement initiatives.
- Excellent verbal and written English and Chinese. Working knowledge of MS office programmes, including excel, word etc
- Analytical, problem solving and decision making skills, leadership
- Flexibility – ability to adapt to changing work practices
- Ability to use own initiative
- Ability to work autonomously to organise own workload effectively and efficiently
About the Company
We are a health insurer and provider. With no shareholders, our customers are our focus. We reinvest profits into providing more and better healthcare for the benefit of current and future customers.
Bupa’s purpose is longer, healthier, happier lives and making a better world.
Here you’ll be welcomed. We champion diversity and we understand the importance of our people representing the communities and customers we serve. You’ll find an inclusive environment where you can be yourself and where everyone is driven by the same purpose – helping people live longer, healthier, happier lives and making a better world.
Bupa Global is the international health insurance division of Bupa. We provide customers who want premium international coverage with products and services to access the healthcare they need anytime, anywhere in the world, whether at home or when studying, living, travelling or working abroad.
Bupa Global has offices around the world including London and Brighton (UK), Miami (USA), Copenhagen (Denmark), Dubai (UAE, in partnership with OIC), and Hong Kong (China) as well as regional offices in mainland China, Singapore, Egypt, Mexico, the Dominican Republic, Bolivia, Brazil, Panama, Guatemala and Ecuador.
Timescales for reviewing applications will differ between regions, but you will always receive a response to your application. The recruitment process itself will vary per role and region, but you will be updated along the way via phone and email (so please look out for these!). To view what stage of the process your application is currently at, you can also log in and view your dashboard.
If you are invited to an interview, a member of the resourcing team will be able to advise you on what to expect. This will vary in region, but will likely include an initial phone or digital interview, followed by one or more of the following depending on the role: Core capability interview; Technical/function specific interview; Online profiling assessment; Presentation, written task, role play; Assessment centre.
If your application is successful and you’re invited to join the team, the resourcing team will guide you through your on boarding journey.
Should you require any reasonable adjustments to be made or facilities provided to enable you to attend an interview, please do not hesitate to contact us prior to the interview at firstname.lastname@example.org, so we can make adjustments accordingly.