Executive / Senior Executive, Benefit Package & Pricing

About the role

The Executive / Senior Executive, Benefit Package & Pricing is responsible for supporting the development, evaluation and continuous improvement of healthcare benefit packages and related pricing strategies to support ProtectHealth’s strategic purchasing objectives.

The role undertakes research, evidence reviews, healthcare market and cost analysis, and stakeholder engagement to support the design of benefit packages that are clinically appropriate, financially sustainable and responsive to population healthcare needs.

The incumbent will work closely with internal and external stakeholders to translate evidence and programme requirements into practical benefit and pricing recommendations, support implementation, and monitor post-launch performance to inform continuous improvement.

Key responsibilities

• Support the design, review and enhancement of healthcare benefit packages covering areas such as primary care, chronic disease management, preventive services, prescription medicines, wellness initiatives and specialised treatments.
• Conduct and coordinate literature reviews, health technology assessments (HTA), market research and other evidence-based analyses to assess the clinical benefit, cost-effectiveness, appropriateness and feasibility of healthcare services, medicines and technologies.
• Analyse healthcare utilisation, cost information, market trends, emerging technologies, supply-demand dynamics and other relevant data to support benefit package and pricing decisions.
• Conduct pricing, reimbursement and market benchmarking analyses to support the development and review of appropriate pricing approaches for healthcare programmes and services.
• Assess the potential financial, operational and programme impact of proposed benefit and pricing changes and provide evidence-based findings and recommendations.
• Support the translation of approved benefit packages and pricing parameters into clear programme requirements, implementation plans and operational guidelines.
• Collaborate with relevant departments including Operations, Finance, Legal, Quality Assurance, Digital Technologies and other stakeholders to ensure benefit and pricing proposals are practical, compliant and operationally feasible.
• Engage healthcare providers, industry stakeholders, subject-matter experts and other external parties to obtain relevant information, validate assumptions and support programme development.
• Support the development and maintenance of SOPs, guidelines, documentation and communication materials relating to benefit package and pricing initiatives.
• Monitor programme and benefit performance through relevant KPIs, utilisation patterns, cost trends and stakeholder feedback, and identify opportunities for improvement.
• Prepare analyses, reports, presentations and management papers to communicate findings, recommendations, risks and proposed actions to Management and relevant stakeholders.
• Maintain appropriate documentation, assumptions, supporting evidence and decision records relating to benefit package and pricing activities.

What we're looking for

• Bachelor’s degree in Health Economics, Public Health, Healthcare Management/Administration, Pharmacy, Economics, Finance, Actuarial Science, Business Administration, Statistics, Data Analytics or another relevant discipline.

• Postgraduate qualifications or relevant professional certifications in healthcare financing, health economics, project management, data analytics or related areas will be an added advantage.

• Relevant experience in areas such as:

  • Healthcare / healthcare financing
  • Health insurance or takaful
  • Health economics / HTA
  • Benefit design or reimbursement
  • Healthcare pricing or cost analysis
  • Strategic purchasing
  • Healthcare analytics
  • Consulting or programme development

• Strong research, analytical and problem-solving capabilities.

• Good written and verbal communication skills in English and Bahasa Malaysia.

• Ability to collaborate effectively with multidisciplinary and cross-functional stakeholders.

• Proficiency in Microsoft Excel and PowerPoint; exposure to analytics or data visualisation tools is an advantage.