Department Head of Provider Relation

About the Role

We are looking for a Head of Provider Relation to lead and manage Meditap's hospital provider network, strengthen strategic relationships with hospital partners, and ensure effective provider operations and commercial efficiency. This role will be responsible for managing the end-to-end provider partnership process, including hospital onboarding, PKS management, commercial negotiation, operational issue resolution, and service improvement.

Key Responsibilities

1. Provider Onboarding & PKS Management

• Identify, map, and approach potential hospital partners based on territory and business needs to expand Meditap’s provider network.

• Manage the end-to-end hospital onboarding process, from initial engagement and negotiation through contract/PKS finalization.

• Ensure new and renewal PKS targets are consistently achieved in line with business and client requirements.

• Monitor the validity and completeness of provider agreements and supporting legal documents.

2. Commercial Negotiation & Cost Efficiency

• Lead negotiations with hospital partners on tariffs, administrative packages, discounts, rebates, and other commercial terms.

• Establish and achieve annual commercial targets related to cost efficiency and provider agreements.

• Analyze hospital utilization and tariff trends to identify opportunities for cost optimization.

• Review tariff changes against Meditap standards and conduct renegotiations with high-volume or strategic hospital partners.

3. Provider Issue Resolution & Operational Support

• Manage and resolve operational issues and complaints from hospital providers, including guarantee delays, claim discrepancies, system access, and other service-related matters.

• Ensure provider issues are followed up and resolved within agreed timelines, or appropriately escalated when required.

• Support Finance and Claims teams in reconciliation processes, including invoice discrepancies and overpayment/underpayment tracking.

• Coordinate with Claim Health and Case Monitoring teams to follow up on critical cases, including cases requiring accelerated approval or suspected fraud investigation.

4. Provider Relationship Management & Governance

• Build and maintain strong, long-term relationships with hospital partners and key stakeholders.

• Conduct regular socialization and re-socialization sessions regarding Meditap’s operational processes, policies, and system usage.

• Ensure hospital partners understand and comply with agreed operational procedures and service standards.

• Coordinate the review of standard legal and corporate documents to ensure hospital credentials and documentation meet Meditap requirements before contract finalization.

5. Service & Team Leadership

• Monitor provider service performance and customer satisfaction KPIs.

• Identify recurring issues and improvement opportunities across the provider network.

• Develop and implement initiatives to improve the provider and member journey.

• Lead, coach, and develop the Provider Relation team to achieve operational, commercial, and service targets.

• Prepare regular performance reports and provide insights and recommendations to management.

Requirements

• Bachelor's degree in Business Administration, Management, Healthcare Management, Insurance, or a related field. Medical Doctor (MD) background or clinical experience is a strong plus.

• Minimum 5 years of relevant experience in Provider Relations, Hospital Relations, Healthcare, TPA, Insurance, or related industries, with experience in a managerial/supervisory role.

• Strong experience in hospital/provider network management and relationship management.

• Proven experience in commercial negotiation, including hospital tariffs, discounts, rebates, and partnership agreements.

• Good understanding of hospital operations, healthcare claims, insurance/TPA processes, and provider management.

• Experience handling provider complaints, operational issues, reconciliation, and cross-functional coordination.

• Strong analytical and problem-solving skills, with the ability to identify cost-saving and process improvement opportunities.

• Strong leadership, communication, negotiation, and stakeholder management skills.

• Strong proficiency in Microsoft Office, particularly Excel and PowerPoint.

• Excellent communication skills.

• Experience in handling sensitive and confidential information in accordance with applicable information security policies and procedures.