Vendor Management Senior Manager

JOB TITLE:

Vendor Sr Manager

DIVISION:

Operations

DEPARTMENT:

Claims Provider and Utilization Management

LOCATION:

GT Tower

REPORTING TO

(ROLE):

Claims Provider and Utilization Management & Medical Director

NUMBER OF DIRECT

REPORTS:

3

MAIN PURPOSE

OF THE JOB:

The role is responsible for planning, directing, and coordinating the medical and health services of the company (function or processes) including management of TPA relationship for hospital network development, management of network of medical specialist , review of processes, and engagement of new partners and processes for medical health services.

This role will oversee the management if vendor relationships and contracts to ensure the delivery of high-quality services and products.

KEY ACCOUNTABILITIES:

·Supervise and ensure smooth administration of health insurance by coordinating operational processes for services related to the company’s medical portfolio, including arranging, and managing TPA partnership or network of medical specialist or relevant service partners for identified critical points across the health journey, including but not limited to:

oAccess to medical network

oClaims administration

oService delivery of well-being/health services ( tele-consultation, wellness & prevention programs)

·Provide operational support: work with operations (UW, etc.) and frontline teams (Branch, Customer Care) to ensure product benefit and service delivery.

·Management of processes across the health journey—define service standards and operating policies towards improving efficiency and quality in delivering customer service; integrate provider services, in-house operations, and governance.

·Continuously review and evaluate the efficiency and effectiveness of service delivery methods, procedures, administrative and support systems; identify areas of improvement and define implementation strategies.

·Facilitate escalation and problem resolution, including corrective action planning by vendor for recurring issues or audit findings.

·Track, measure, report, and evaluate vendor performance according to contractual obligations and agreed-to service standards.

·Conduct periodic reviews with providers and business units to discuss vendor performance, issues, corrective actions, and anticipated events or changes.

·Put in place tools necessary for measuring vendor / medical specialist performance.

·Plan, direct, and spearhead health services initiatives and key partner programs

·Collaborate with internal stakeholders, including procurement, legal and operational teams, to address vendor-related issues and drive continuous improvement.

·Keep abreast on current healthcare practices, changes in regulations, technology, and customer preferences to drive innovation and efficiency in vendor relationships.

KEY

STAKEHOLDERS:

Internal: Claims Leadership Team, Operations Leaders, COO, Finance

External: Network Partners, Clients, Distributors

EXPERIENCE & QUALIFICATION

·Bachelor’s degree in business, healthcare administration or related field

·Minimum 7 years of experience in managing medical / health insurance operations or administration from HMO or insurance company or vendor management, procurement in the health care industry

·Experience in setting up and/or managing operations processes supporting medical or HMO products, managing networks of Medical Specialist

·Experience in claims management and/or medical background preferred.

·Strong understanding of healthcare regulations, compliance requirements and industry standards

·Proven track record of successfully managing vendor relationships and contracts to achieve cost savings and operational efficiencies.

·Excellent negotiation, communication, and interpersonal skills.

·Ability to lead and develop a high performing vendor management team.

·Expert knowledge of the healthcare insurance market and relevant practices and regulations, and product solutions

A global leader in insurance and investments, AXA takes care of 103 million lives in 64 countries worldwide. We actively invest in pioneering and personalized solutions to meet your ever-changing needs and exceed your expectations. In the Philippines, we are in partnership with Metrobank, one of the country's strongest banks.

Established in 1999, AXA Philippines is one of the largest and fastest growing life insurance companies in the country. It offers financial security to more than one million individuals through its group and individual life insurance as well as general insurance products through its subsidiary Charter Ping An.

AXA Philippines is one of the first to introduce bancassurance operations in the country, and is among the pioneers in the investment-linked insurance sector.

AXA now offers a complete range of products for all its customers’ insurance and financial protection needs, including savings and investments, health plans, income protection, and health coverage; and through its general insurance subsidiary Charter Ping An Insurance Corporation: fire, motor car, marine cargo, personal accident, bonds, casualty, and engineering insurance products.

AXA Philippines closed 2017 with billion in total premium income and billion in gross written premiums from Charter Ping An. Today, AXA has more than 4,000 financial advisers in 36 branches, and 700 financial executives in over 900 Metrobank and PSBank branches nationwide. Charter Ping An, on the other hand, has 22 branches nationwide and 2,007 agents.

AXA Philippines is a joint venture between the AXA Group, headquartered in France, and the Metrobank Group, one of the largest financial conglomerates in the Philippines.

The Metrobank Group is a conglomerate of industry-leading businesses that includes First Metro Investment Corporation, Metrobank Credit Cards, Federal Land, Toyota, and Manila Doctors Hospital. It was hailed Best Bank in the Philippines in 2010, 2011, and 2012 by Euromoney and recognized as the strongest bank in the Philippines by The Asian Banker in 2013. It is owned by the Ty Family whose major business interests include financial services, real estate development, power, and manufacturing.