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, cost‑effective medical provider network. Reporting to the Senior Manager or Head of Department, the role ensures members receive accessible healthcare while optimizing financial performance.

Key responsibilities

• Support and drive the strategic direction set by MPM leadership.
• Develop and execute cost‑saving initiatives aligned with financial targets.
• Build and maintain a robust network of hospitals, physicians, diagnostics and ancillary services.
• Negotiate contracts with providers to secure favorable terms and revenue opportunities.
• Foster strong relationships with network providers, addressing issues promptly.
• 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 teams.
• Prepare and present regular performance reports to senior leadership.
• Utilize AI, machine learning, data analytics and cloud‑based tools while adhering to data governance and security standards.

Required profile

• Bachelor’s degree in healthcare administration, business administration or a related field (Master’s preferred).
• 5‑7 years of experience in healthcare network management.
• Strong knowledge of healthcare regulations, accreditation standards and regional medical industry dynamics.

Required skills

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