provider network manager

Job Description

Role Summary

The Provider Network Manager leads and governs the healthcare provider network to ensure strong provider partnerships, service quality, and regulatory compliance. This role drives network expansion and optimisation, oversees provider contract negotiations and performance management, and acts as the senior escalation point for provider-related matters.

The role also oversees cross-border operations, ensuring effective coordination between Malaysian providers and regional teams. Working closely with internal stakeholders, including Marketing and Operations, the Provider Network Manager supports provider-focused initiatives, special projects, and continuous improvement efforts, while leading and developing the Provider Network team.

Job Responsibilities:

Provider Relationship & Network Management

• Demonstrate strategic leadership in managing provider relationships, ensuring alignment with organisational goals and long-term network strategy.
• Exercise sound judgement and accountability as the senior escalation authority for high-impact provider issues, disputes, and complex negotiations.
• Establish governance standards and direction for provider communications, driving clarity, consistency, and professional engagement across teams.
• Lead and influence provider engagement strategies and initiatives, ensuring effective execution of network updates, operational changes, and cross-functional programmes involving providers.
• Implement initiatives aligned with business goals, cost efficiency, and service quality.

Network Development & Contract Management

• Define and drive provider network expansion and optimization strategy, overseeing the identification, evaluation, and onboarding of healthcare providers to strengthen network coverage.
• Lead and govern provider contract negotiations, ensuring commercial terms, pricing, and service expectations align with organisational objectives.
• Ensure effective contract governance, with timely review and updates in compliance with regulatory and organisational standards.

Cross-Border Operations Oversight

• Oversee cross-border operations to ensure seamless coordination & communication between Malaysia providers, HMS Indonesia Team and HMS Malaysia Team for effective operational outcomes.

Provider Performance & Quality Assurance

• Govern provider performance management to ensure service quality, compliance and operational excellence across the provider network.
• Drive corrective action plans and continuous improvement initiatives. This includes collaboration with relevant internal / external parties to address quality gaps and service issues.

Marketing & Special Projects Collaboration

• Partner with the Marketing team on initiatives involving healthcare providers, including network promotion, provider engagement campaigns, client events, and brand-related activities.
• Support marketing-led projects by providing provider insights, validating network information, and coordinating provider participation where required.
• Represent the Provider Network function in special projects or cross-functional initiatives involving providers, including pilot programmes, strategic partnerships, new product launches, or process transformation efforts.
• Ensure provider readiness, alignment, and compliance for special projects, working closely with internal stakeholders and providers throughout execution.

Data Analysis & Reporting

• Analyze provider data and performance metrics to identify improvement opportunities.
• Apply data-driven insights to enhance network efficiency and effectiveness.

Compliance & Governance

• Ensure provider network compliance with healthcare regulations and company policies.
• Stay informed on regulatory changes impacting provider relationships.
• Maintain SOPs and governance frameworks for provider and cross-border operations.

Team Leadership & Collaboration

• Lead, coach, and develop the Provider Network team
• Foster strong cross-functional collaboration across internal departments to support organisational objectives.
• Demonstrates professional maturity in line with the company's core values.
• Contribute to an effective team environment by interacting professionally with all team members and providing development, support, and assistance as required

Additional Responsibilities

• Participate in project/initiatives related to provider network and cross border operations from time to time.
• Perform other related duties as assigned by line manager or other appropriate officer.
• Participate in business process improvement initiatives to support operational excellence.
• Ensuring compliance with all legal, statutory, and company affairs requirements on a timely basis
• Occasional travelling is required.

Experience and Qualification

• Bachelor's degree in healthcare management, Business Administration, Operations, or a related field.
• At least 2 - 4 years of experience in provider network management, healthcare operations, insurance, TPA, or managed care.
• Proven experience managing hospital/provider relationships and contracts.
• Exposure to cross-border healthcare operations or international patient coordination is an advantage.
• Strong communication, negotiation, and problem-solving skills.
• Ability to multitask
• Excellent organizational and time management abilities
• Tech-savvy, with strong proficiency in Microsoft tools; experience with Zendesk is an advantage.

Job Snapshot

Updated Date

Job ID

JOB-135

Department

Provider Network

Location

Subang Jaya, Selangor, Malaysia

Experience

2 - 4 Years

Employee Type

Permanent (On Probation)

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