Provider Network Manager
Blueventure TPA Co., Ltd.Financial/Banking/Securities, Insurance
28/02/2025
Full Time
1 - 8 Year
Bangkok
Bachelor's Degree or Higher
40,000 - 60,000 baht/month
1. Network Expansion & Optimization:
• Develop and implement strategies to expand and strengthen BlueVenture TPA’s provider network.
• Identify potential healthcare providers (hospitals, clinics, pharmacies, diagnostic centers) for partnership.
• Negotiate contracts with new providers to ensure competitive pricing and service quality.
2. Contracting & Fee Negotiation:
• Conduct negotiations on tariffs, discount structures, and service agreements with healthcare providers.
• Regularly review and renegotiate contracts to align with market trends and cost-control strategies.
• Ensure that contract terms comply with regulatory requirements and business objectives.
3. Relationship Management & Provider Engagement:
• Act as the primary liaison between BVTPA and network providers to ensure smooth collaboration.
• Address provider concerns, resolve disputes, and improve service efficiency.
• Conduct regular provider meetings, workshops, and training sessions.
4. Performance Monitoring & Quality Assurance:
• Establish KPIs to monitor provider service quality, turnaround time, and claims efficiency.
• Implement provider audits to assess compliance with contract terms and service standards.
• Work closely with internal teams to analyze provider performance data and recommend improvements.
5. Claims & Billing Coordination:
• Ensure that providers follow the agreed billing process to minimize claims disputes.
• Collaborate with the claims processing team to resolve billing discrepancies and payment delays.
• Support automation initiatives to improve claims submission and payment turnaround times.
6. Market Research & Competitive Benchmarking:
• Monitor market trends in provider tariffs, reimbursement models, and emerging healthcare services.
• Conduct benchmarking analysis to maintain a competitive and cost-efficient provider network.
• Provide insights on market developments and recommend adjustments to network strategies.
• Education: Bachelor’s or Master’s degree in Healthcare Management, Business Administration, or a related field.
• Experience: Minimum 5-7 years in provider network management, healthcare administration, or a similar role in TPA, health insurance, or hospital networks.
• Strong contract negotiation and provider relationship management skills.
• In-depth knowledge of healthcare pricing models, reimbursement structures, and claims processing.
• Understanding of regulatory frameworks affecting provider networks and health insurance.
• Data analysis and reporting skills to assess provider performance.
• Proficiency in AI-driven healthcare analytics (preferred).
• Excellent communication, stakeholder management, and problem-solving skills.
• Language: Fluency in Thai and English is required.
- Provident Fund
- Staff training and development
- 5-day work week
- Social security
- Health insurance
- Accident Insurance
- Flexible working hours
- Annual bonus
Blueventure TPA Co., Ltd.ให้บริการสนับสนุนการปฏิบัติงานของธุรกิจประกันภัยและบริษัทเอกชน ได้แก่ การบริหารจัดการ สินไหมทดแทนการรักษาพยาบาลของบริษัทประกันภัย และการบริหารจัดการสวัสดิการรักษาพยาบาลของบริษัทเอกชน รวมถึงการให้คำปรึกษา และจัดอบรมให้แก่บุคลากรของธุรกิจประกันภัย เพื่อเพิ่มความสามารถในการแข่งขันและเพิ่มประสิทธิภาพในการดำเนินงานให้กับลูกค้า และสร้างความพึงพอใจให้กับผู้ใช้บริการ
Location48/16 ซอยรัชดาภิเษก 20 ถนนรัชดาภิเษก แขวงสามเสนนอก เขตห้วยขวาง กรุงเทพมหานคร 10310
Contact personฝ่ายทรัพยากรมนุษย์
Telephone064-131-6959
