Senior Local Medical Provider Manager

About the role

The Senior Local Medical Provider Manager will lead the development, implementation, and ongoing management of a high‑quality medical provider network. Reporting to senior leadership, the role ensures cost‑effective, accessible healthcare services for members while driving revenue through strategic negotiations and network optimization.

Key responsibilities

• Support and execute the MPM strategy, delivering cost‑saving initiatives aligned with financial targets.
• Develop and maintain a robust network of hospitals, physicians, diagnostics and ancillary providers.
• Negotiate contracts with providers to secure favorable terms, cost‑effective care, and revenue opportunities.
• Build and sustain positive provider relationships, addressing issues promptly and escalating when needed.
• Ensure compliance with internal policies, local regulations, and accreditation standards.
• Monitor network performance metrics (cost, quality, accessibility) and lead improvement projects.
• Collaborate with Claims, Business Development, CRM, Operations, and Finance to achieve organizational goals.
• Prepare regular performance reports for senior leadership.

Required profile

• Bachelor’s degree in healthcare administration, business administration or related field (Master’s preferred).
• 5‑7 years of experience in healthcare network management.
• Strong negotiation and contract management capabilities.
• Excellent communication, analytical and problem‑solving abilities.
• In‑depth knowledge of healthcare regulations and accreditation standards.

Required skills

• AI
• Machine learning
• Data analytics
• Cloud‑based tools