Lead - Provider Network

Opportunity to set up the vertical from scratch Competitive Pay About Our Client The hiring company is the insurance arm of a leading conglomerate across the country. Job Description 1. Network Strategy & Digital Transformation:● Network Development & Expansion: Lead the design and execution of strategies to expand and enhance the P&C provider network, integrating digital technologies for the optimization.● Develop and execute the organization's strategic network plan to ensure the provider network aligns with business goals, member needs, and regulatory requirements.● Continuously assess the network to identify opportunities for expansion, optimization, and improvement in both geographic and specialty coverage.● Analyze market trends, competitor networks, and demographic data to make data-driven decisions about network composition and growth.● Digital Tools Integration: Drive the adoption of advanced digital tools (, claims automation, predictive analytics, cloud-based platforms) to improve network operations, provider management, and care coordination. This includes leveraging data analytics to optimize provider performance and identify trends for network improvement.2. Vendor & Provider Relationship Management with Digital Support:● Lead negotiations and long-term relationships with service providers (garages, contractors, lawyers, medical assessors, etc.).● Manage end-to-end procurement lifecycle: RFI/RFP, contracting, onboarding, and performance management.● Oversee SLAs, compliance, and service quality audits.● Foster strategic partnerships and alliances that enhance network value and scalability.3. Operational Efficiency & Data-Driven Network Optimization:● Network Performance Monitoring: Leverage advanced data analytics and AI to monitor network performance, identifying gaps in care, inefficiencies, or opportunities to enhance member experience.● Lead digital integration of the service network (, APIs for FNOL, digital repair tracking, e-invoicing).● Collaborate with product and IT teams to automate claims workflows using provider platforms.● Evaluate and implement insurtech partnerships for virtual assessments, photo estimation, and AI-assisted repair decisions.● Drive digital transformation of provider interfaces and customer self-service touchpoints.4. Compliance, Regulatory, and Digital Risk Management:● Regulatory Compliance: Ensure provider agreements and operations comply with local regulatory, legal, and data protection requirements.● Digital Security & Privacy: Work closely with IT and cybersecurity teams to ensure data privacy and security protocols are followed● Risk Management: Use data analytics to predict and manage network risks, including provider performance, member access, and fraud prevention. Leverage digital tools for fraud detection, such as AI-driven claims analysis, to reduce fraud in the network.● Represent the company in external audits or regulator engagements as required.● Ensure ethical and fair practices across the network.5. Performance, Financial & Cost Control with Digital Insights:● Financial Strategy: Leverage digital analytics to manage and optimize network costs. Use predictive modeling and cost-analysis tools to identify opportunities for cost savings while maintaining high-quality care.● Cost-Effective Provider Networks: Implement strategies to reduce unnecessary hospital readmissions and emergency room visits through enhanced digital care coordination, predictive analytics, and remote patient monitoring, driving down costs.● Monitor provider performance using real-time dashboards and analytics (, repair cycle time, cost per claim, customer satisfaction).● Identify and mitigate leakage or fraud risks within the network.● Develop incentive models to drive provider efficiency and alignment with customer Team Leadership & Digital Skills Development:● Lead the Network Management Team: Provide leadership, mentorship, and coaching to the network management team, fostering a culture of innovation, digital literacy, and continuous improvement.● Develop Digital Competencies: Ensure that the network management team is skilled in using digital tools, platforms, and data analytics. Provide ongoing training on digital technologies to ensure team members stay up-to-date with industry advancements. The Successful Applicant A successful Lead - Provider Network should have:● Deep understanding of P&C N/w processes (FNOL to settlement).● Familiarity with the systems, digital workflow tools, and provider portals.● Strong data analytics skills; experience with BI dashboards (, Power BI, Qlik).● Knowledge of repair estimating tools (Audatex, Mitchell, etc.) and telematics data is a plus.● Experience managing budgets, negotiating contracts, and identifying cost-saving opportunities through the strategic use of digital solutions.● Commercial acumen in vendor contracting and service pricing.● Change management and cross-functional collaboration capabilities.