Provider Services Specialist -

Role Overview

Reporting to the Senior Manager Provider Services, the Provider Services Specialist will be responsible for supporting the implementation of our out of hospital healthcare provider relationship strategy to improve our customers health care experience, enable delivery of best practice care and build strong collaborative relationships with medical and non-hospital healthcare providers to enhance our customer value propositions.

The role will support the end-to-end management of our out of hospital clinics and medical consultants. Responsibilities will include contract negotiations, ongoing relationship management and monitoring of the provision of quality, appropriate and innovative services to ILH members. You will have the opportunity to grow your career, enhance your existing skills, and gain exposure to other aspects of the business.

The successful candidate will have a strong commercial focus / good business and financial acumen, experience in negotiations and will be able to demonstrate an ability to work on their own initiative. 

The key responsibilities of the role will include:

•    Support in the implementation of our annual and medium-term negotiation strategy for medical consultants, ensuring a positive outcome for ILH and value for ILH customers.
•    Support in the negotiation and management of contracts and agreements with medical consultants and out of hospital providers that encourages a cost effective and quality driven agenda on behalf of ILH and our members. 
•    Develop a deep understanding consultant activity, claims patterns and associated outcomes.
•    Continuously review schedule rules/codes in terms of pricing and in line with Consultant issues, new developments, technologies etc, in conjunction with ILH clinical personnel.
•    Perform data analysis and reporting on codes in usage, volumes, and to support potential changes.
•    Support in the end-to-end delivery of our annual schedule of medical professional fees.
•    Resolve contract/schedule issues and support management in resolution of issues raised.
•    Manage interactions with billings agencies in respect of day-to-day claim queries and annual distribution of our schedule of medical professional fees.
•    Liaise and manage issues with internal ILH teams in relation to the schedule of medical professional fees.
•    Support the team in devising a plan of action that will allow for internal changes to processes and product offerings as a result of changes in the market, specifically as Slaintecare evolves which will directly impact the medical consultant area.
 

What you will help us to achieve

•    A relevant specialist third level qualification
•    Good financial experience, with at least 2 years or more in a similar role, preferably in a Private/Public Hospital or Private Medical Insurer. 
•    Have a strong commercial focus and excellent business acumen.
•    A proven track record in establishing a rapport and trust that facilitates an open dialogue that will ultimately lead to more efficient and transparent negotiation process.
•    Ability to negotiate in a fast moving and pressure situation
•    Strong understanding of the healthcare industry
•    Flexibility to attend occasional onsite meetings
•    A passion for delivering excellent customer service and improving the member experience

The individual selected will be motivated to make a difference and play a very significant part in the delivery of our business objectives.

Skills: 

•    Excellent communication and negotiating skills
•    Strong numerical capability
•    Medical provider knowledge
•    Proven interpersonal skills
•    Attention to detail and good follow through
•    Highly motivated
 

Key Competencies