Provider Networks Manager wanted – AVIVA – SG

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PURPOSE OF THE ROLE
The need for effective and extensive clinical management through the establishment of integrated preferred provider networks (PPN’s) has been identified as an essential element of Aviva’s healthcare strategy to achieve sustainable profitability without putting excessive upward pressure on price to client and to maintain Aviva Ltd.’s market positioning.
The Provider Networks Manager will be expected participate in the development of PPN strategy and in due course to lead the development of PPN’s.
The Provider Networks Manager will implement these PPN’s in such a way as to achieve meaningful savings whilst respecting the needs of our clients and providers.
The Provider Networks Manager will contribute to the ongoing development and adaptation of these PPN’s over time in line with our developing strategy and needs.
The Provider Networks Manager will be responsible for training staff to interact with providers within the strategy developed for PPN’s.

ACCOUNTABILITIES
Strategic
To assist in the establishment of and then manage a new PPN strategy for Aviva designed to reduce operational losses whilst maintaining quality of care for our clients.
Operational
Convert strategy into practical and effective management.
Monitor quality and appropriateness of medical care.
Contribute to the overall Aviva Health strategy by interacting with the Medical director.
Effective Risk Management/Governance
Monitor and evaluate clinical risk associated with the PPN’s, associated interventions and operational activity.

OUTCOMES
Under the leadership of the Medical Director establish (together with our selected risk manager should such exist) a comprehensive set of PPN’s based on best medical practice so as to both ensure quality outcomes for our clients as well as manage our claims’ expenditure.
Practically implement effective analytical measures based on established clinical protocols into the PPN relationships in such a manner as to effectively monitor provider behaviour.
Interact with claims colleagues at Aviva Health Singapore to ensure that the goals and benefits of the PPN strategy are understood and supported.
Ensure that PPN structures support the coordination of care across a variety of settings (outpatient, ER, home care) while maintaining strict confidentiality and the highest level of professionalism
QUALIFICATIONS
Bachelors degree or business administration qualification preferred but not essential.
Possible clinical qualification.
KNOWLEDGE/EXPERIENCE
Experience in the drafting and implementation of contracts.
Reasonably numerate and demonstrates understanding of financial modelling and analysis.
Insurance or Employee Benefits Administration or Claims Management.
Understanding of the Singapore Insurance market or healthcare delivery.
Knowledge of healthcare services, policies and surrounding legislation.
SKILLS
Methodical; able to envision a plan and carry it through to completion.
Negotiation, coaching and communication skills.
Strength of character and confidence.
Relationship building.
Ability to interact confidently at all levels.
Business & Financial Acumen.
Numeracy levels both to understand the Profit & Loss drivers and identify where the key opportunities lie
Ability to assess complex issues, to determine and implement their solutions.
Passionate about changing the healthcare experience for our members and improving their health
Respond to challenges with patience, empathy, and tenacity while maintaining a flexible attitude.
Have intermediate or advanced computer literacy skills
Quality Assurance.
Customer Experience.