POSITION Group Head of Insurer Relations
Reporting to Group Chief Financial Officer
Base Group Head Office, Fonthill
Working Hours 37 hours per week
Key stakeholders
Group Chief Financial Officer
Group Chief Transformation Officer
Hospital CEO's including Blackrock Clinic, Hermitage Clinic, and Galway Clinic
Group Chief People Officer
Group Chief Information Officer
Group Clinical Director
Hospital Directors of Nursing
Hospital Heads of Quality
Hospital Heads of HR
Role purpose
The Head of Insurer Relations will lead the strategic development, negotiation, and ongoing management of commercial relationships with private medical insurance (PMI) providers. This role ensures optimal reimbursement rates, secures profitable network agreements, and drives sustainable revenue growth for the hospital group or healthcare network.
Key responsibilities
Strategic Contract Negotiation
-
Lead all commercial negotiations regarding tariff rates, pricing structures, and service-level agreements (SLAs) with major health insurance companies.
-
Secure optimal reimbursement for clinical services, diagnostic tests, surgical procedures, and inpatient bed days.
-
Design and pilot innovative risk-sharing models, value-based care agreements, and bundled payment initiatives.
Relationship & Stakeholder Management
-
Serve as the primary escalation point and senior contact for all private medical insurance partners.
-
Resolve complex billing disputes, underwriting bottlenecks, and coverage disagreements collaboratively.
-
Partner internally with Clinical Directors and Operations Teams to align clinical capabilities with insurer-approved pathways.
Commercial Performance & Financial Analytics
-
Analyse claims data, rejection rates, and utilisation trends to minimise revenue leakage and maximise yield.
-
Track key performance indicators (KPIs) Days Sales Outstanding (DSO), and contract profitability.
-
Provide accurate revenue forecasting and financial modelling during annual budget and contract renewal cycles.
Market Intelligence & Regulatory Compliance
-
Monitor healthcare policy changes, medical inflation trends, and competitive insurance product launches.
-
Ensure all commercial contracts strictly comply with local healthcare regulations, data protection standards, and corporate governance.
Qualifications and experience
-
Bachelor's degree in Business, Finance, Healthcare Administration, or a related field (Master's/MBA preferred).
-
Minimum 7-10 years of senior commercial experience in healthcare management, private medical insurance, or managed care.
-
Proven success leading high-value commercial negotiations and managing substantial insurance contracts.
-
Skills & Competencies
-
Exceptional commercial acumen with a firm but collaborative negotiation style.
-
Advanced ability to interpret complex financial data, actuarial trends, and hospital billing metrics.
-
Highly articulate presenter able to influence C-suite executives and external insurance leaders.
-
The requisite knowledge and ability (including a high standard of suitability and management ability) for the proper discharge of the duties of the office.
This job role profile is subject to periodic review and may be updated as needed.
September 2026