Lead - Provider Network

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.