Head Provider Network Management

About the role

The Head, Provider Network Management will lead the strategic development, governance and performance of ProtectHealth’s healthcare provider network for the MediAsas programme. The role oversees the end-to-end provider lifecycle, including empanelment, onboarding, performance management, contract administration and provider relationships, while driving cost containment, care outcomes and Fraud, Waste & Abuse (FWA) initiatives. The incumbent will also lead commercial negotiations, strengthen provider performance and compliance, and work closely with internal and external stakeholders to ensure a high-quality, efficient and sustainable provider network.

Key responsibilities

• Lead the strategy, development and optimisation of the healthcare provider network.
• Oversee the end-to-end provider lifecycle, including empanelment, credentialing, onboarding, renewal, suspension and termination.
• Drive provider performance through KPIs, SLAs and continuous improvement initiatives.
• Build and maintain strong relationships with healthcare providers, vendors and strategic stakeholders.
• Lead commercial negotiations and support healthcare cost-containment initiatives.
• Collaborate with the Analytics team to monitor utilisation, provider performance, costs and care outcomes.
• Support the identification and management of Fraud, Waste & Abuse (FWA).
• Ensure provider operations comply with organisational, contractual and regulatory requirements.
• Drive process improvement and digitalisation within provider network management.
• Lead, coach and develop the Provider Network Management team.

What we're looking for

• Bachelor’s Degree in Healthcare Management, Medicine, Pharmacy, Nursing, Allied Health, Business Administration, Health Administration or a related discipline.
• Approximately 10 years of relevant healthcare industry experience, preferably within hospitals, health insurance, managed care, TPA or provider network management.
• Strong hands-on experience in provider/panel network management.
• Experience in FWA and/or healthcare cost containment.
• Strong commercial negotiation, contract and stakeholder management capabilities.
• Demonstrated leadership and people-management experience.
• Experience in patient/care outcome management or analysis would be an added advantage.

You’ll be a strong fit if you are:

Strategic yet operationally hands-on, commercially astute, data-driven, comfortable managing complex healthcare stakeholders, and passionate about building a high-performing and sustainable healthcare provider network.