Global Network Pricing Specialist

Essential Job Duties and Responsibilities:

The Global Network Pricing Specialist, is an expert role responsible for the coordination of activities including provider-facing and administrative functions that support the pricing and cost containment efforts for delivering healthcare assistance under the project.  The specialist works with the service delivery team to ensure travelers receive appropriate care while controlling claim costs—especially in high-cost regions like the U.S.—by applying negotiated pricing models and proactive cost-control mechanisms.

The role requires a combination of expert knowledge in healthcare pricing internationally and commercial orientation to understand key network drivers, evaluate tactical choices and options considering the potential impact on network adequacy and access to care. The incumbent is also responsible to achieve the optimum level of balance between  provider network management, insured travellers’ care outcomes and client financial benefits.

Description:

• Responsible for contractual deliverables regarding negotiated rates in high-activity countries.
• Lead, develop and implement the year-to-year strategy and plans of action to identify highly utilized providers in high-activity country Locations, providers where costs are known to be high.
• Conduct data reviews, analysis, research, and comparison by means of provider price lists to identify highly utilized services.
• Report Management and Recording Pricing analysis outcomes and Discount inventory
• Country reports/ Claim line reports/ Pricing reports/ Power BI reports
• Record of provider engagements as well as provider fees, negotiated rates or discount arrangement recorded in a central provider database (SPIN)
• Oversee and govern a sub network suitable for the project delivery (Customer/ Program owner in SPIN)
• Provider Pricing Anomalies- Direct support to Program Integrity in the event of pricing anomalies being identified.

Job profile

Required Work Experience:

• Successful record in management or customer service experience
• Minimum 5 years of experience within the International Healthcare field
• Solid understanding of international healthcare and pricing systems, ideally across various countries and continents

Required Qualifications:

• Educated to University degree level

Travel Requirements:

• International business travel as required