Provider Services Specialist
17 hours ago
Company: Irish Life Group Services Limited
- Full Time Permanent position
- Hybrid role based in our Dublin or Cork Offices
What we offer
We have embraced a hybrid working model for most of our positions, allowing for a balanced approach of working from home part of the week and from the office the remainder. We offer a comprehensive benefits package including competitive salaries and bonuses, robust Learning and Development support, excellent Defined Contribution pension, and comprehensive Wellbeing initiatives.
Reporting to the Senior Manager Provider Services, the Provider Services Specialist will be responsible for the end-to-end management of our dedicated dental partner (including all associated direct settlement dental clinics) and partner pharmaceutical companies. This role involves working closely with our dental providers and pharmaceutical partners to assist with service and commercial development. You will have the opportunity to grow your career, enhance your existing skills, and gain exposure to other aspects of the business.
What you will help us to achieve
• Daily proactive contract management of service levels and contractual obligations with our dedicated dental partner and all direct settlement dental providers.
• Oversee dental contract governance and build strong cross-functional working relationships with key business stakeholders such as IT, Claims Operations, Propositions, Risk, and Compliance functions.
• Lead all annual negotiations with our dedicated Dental partner on appropriate rates for the entire network that supports a cost-effective and quality-driven agenda on behalf of ILH and our members.
• Review complaints/feedback logs highlighting service issues to be addressed.
• Manage Operations and Quarterly Business Review meetings with our dedicated dental partner ensuring operational items are raised and managed through to resolution.
• Support the onboarding of new dental providers into our dental network by coordinating claim payment systems and rates schedules.
• Act as a key point of contact and relationship manager with our Dental Advisor ensuring claim reviews are completed in a timely manner.
• Review daily claims review reports and act as a liaison with our internal claims teams and our Dental Advisor.
• Maintain, assess, review, and implement changes to our Dental Schedule of Benefits, where appropriate and on an ongoing basis.
• Manage effective communications with key pharmaceutical companies and the NCPE to capture all newly approved drugs and share intel that will help inform ILH pricing assumptions.
• Develop a deep understanding of ILH drug spend activity, claims patterns, and associated outcomes, and work with relevant senior stakeholders to help deliver on the overall business strategy.
What you will need to be successful in the role
• A relevant specialist third-level qualification.
• Good financial experience, with at least 2 years or more in a similar role, preferably in a Private Hospital, Dental Provider, Private Medical Insurer, or Pharmaceutical industry.
• Strong commercial focus and excellent business acumen.
• Proven track record in establishing rapport and trust that facilitates an open dialogue leading to a more efficient and transparent negotiation process.
• Ability to negotiate in fast-moving and pressure situations.
• Strong understanding of the health/dental industry.
• Flexibility to attend occasional onsite meetings.
• A passion for delivering excellent customer service and improving the member experience.
Skills:
• Excellent communication and negotiating skills.
• Strong numerical capability.
• Medical provider knowledge.
• Proven leadership/interpersonal skills.
• Attention to detail and good follow-through.
• Highly motivated.
About us
Irish Life is one of Ireland’s largest financial institutions with a presence across a range of financial services markets. We are one of Ireland’s leading financial services groups with over 1.5 million customers. For over 80 years, we’ve been helping people to look after their life insurance, pension and investment needs, and more recently their health insurance.
It is a subsidiary of Great-West Lifeco and a member of the Power Financial Corporation group of companies.
We are proud of our culture of developing and supporting the growth and professional development of our people.
Irish Life is proud to be an Equal Opportunities employer. We have created an environment of inclusion and growth to help people achieve their potential, to ensure they can bring their whole selves to work and to feel valued. We celebrate diversity of thought and perspective and want all of our employees to feel valued, respected and supported.
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