Head of Medical Affairs & Provider Programs

iCare HMO; Makati; On-site; PHP 1,800,000 - 3,400,000; Full time

Job summary

iCare HMO in the Philippines seeks a senior medical affairs leader to shape strategy and oversee provider relations, clinical governance, and utilization management across the network. This role focuses on improving care quality, cost efficiency, and member satisfaction within a dynamic healthcare environment.

Reporting to the Chief Medical Officer, the Head of Medical Affairs will coordinate credentialing, ensure regulatory compliance, and guide medical decisions while driving preventive health

Qualifications

• Licensed Medical Doctor with current license.
• Preferably with HMO/insurance, diagnostic clinic experience.
• Minimum 5 years of experience as Head of Medical Affairs.

Responsibilities

• Act as co-lead in dealings with provider groups for medical practice matters.
• Ensure provider network meets utilization cost and quality goals.
• Oversee clinic management and coordination with company clinics on utilization management.
• Provide medical guidance for utilization management issues (Prior Authorization, Concurrent Review, Retrospective Review).
• Co-manage the Medical Provider and Services Division, including staff coaching.
• Lead or participate in healthcare programs and preventive health initiatives for clients.

Skills

Leadership

Healthcare management

Provider relations

Regulatory compliance

Education

Licensed Medical Doctor

Tools

Microsoft Excel

Microsoft Word

Microsoft PowerPoint

Microsoft Outlook

Job description

iCare HMO in the Philippines seeks a senior medical affairs leader to shape strategy and oversee provider relations, clinical governance, and utilization management across the network. This role focuses on improving care quality, cost efficiency, and member satisfaction within a dynamic healthcare environment.

Reporting to the Chief Medical Officer, the Head of Medical Affairs will coordinate credentialing, ensure regulatory compliance, and guide medical decisions while driving preventive health