- Location
- Hong Kong - Cityplaza - L13
- Type
- Full-time
- Department
- IT
- Seniority
- Lead
- Experience
- 10+ years
- Source
- Workday
Description
About FWD Group
FWD Group (1828.HK) is a pan-Asian life and health insurance business that serves approximately 40 million customers across 10 markets, including BRI Life in Indonesia. FWD’s customer-led and tech-enabled approach aims to deliver innovative propositions, easy-to-understand products and a simpler insurance experience. Established in 2013, the company operates in some of the fastest-growing insurance markets in the world with a vision of changing the way people feel about insurance. FWD Group is listed on the main board of the Hong Kong Stock Exchange under the stock code 1828.
For more information, please visit www.fwd.com
PURPOSE
- Own and formulate the Group framework for provider quality, network adequacy, contracting discipline, service standards and ecosystem partnerships that underpin profitable health growth.
- Lead clinical standards and clinical governance relating to networks, partnerships and proposition design to protect FWD’s reputation and manage clinical risk.
- Lead and develop a team to build provider-network and partner capability across markets, with a specific mandate to lead capability building in Tier B markets while providing SME support to Tier A.
KEY ACCOUNTAIBILITIES
- Develop and own the Group framework and standards for provider ecosystem development, network design, panel adequacy, service standards and provider-contracting principles (including rate-card and chart-to-bill standards).
- Define network quality and clinical rules, hospital chart-to-bill expectations and provider-performance measures and embed utilisation and cost-containment controls across markets.
- Set network-adequacy and panel-quality criteria by market and monitor compliance, escalating quality or reputational risks to the Group Head of Health.
- Lead clinical evaluation of new propositions, programmes and partnerships, providing clinical sign-off within delegated authority to protect FWD’s clinical reputation.
- Lead the clinical-excellence guild and cross-market collaboration to build reusable provider-management playbooks (contracting, service levels, cost containment, utilisation monitoring).
- Identify cross-market network synergies, shared provider partnerships and regional contracting opportunities.
- Lead Tier B clinical and provider-management capability building and provide SME input to Tier A markets.
- Partner with the Payment Integrity & Performance lead, actuarial, claims and data teams to connect clinical and network standards to loss-ratio and combined-ratio (CoR) outcomes.
- Develop advanced contracting levers — bundled payments, risk-share and co-development arrangements — and rate-card / fee-schedule standards to help bend the medical-cost curve.
- Run the clinical governance forum and clinical sign-off process and maintain the Health clinical standards and clinical risk register.
- Lead and develop the clinical and provider-network team and the clinical-excellence guild, coaching market clinical leads and building bench strength in Tier B markets.
QUALIFICATIONS / EXPERIENCE
- Minimum 10 years’ experience in health / clinical, provider-network or managed-care leadership in multi-market environments.
- Clinical or healthcare qualification; significant knowledge and cultural understanding of Asia health markets.
- Proven experience leading high-performing teams and implementing strategic frameworks across markets with tangible outcomes.
- Proven experience designing provider networks, clinical services and managed-care arrangements and negotiating provider contracts in Asian markets.
- Demonstrated experience embedding clinical governance and clinical risk frameworks across multiple markets.
KNOWLEDGE & TECHNICAL SKILLS
- Comprehensive knowledge of provider contracting and network design; clinical governance and clinical risk.
- Chart-to-bill / R&C standards; utilisation and cost-containment levers; Asia provider ecosystems.
- Extensive knowledge of regional health regulations, standards and protocols.
- Knowledge of value-based care, bundled-payment and risk-share contracting models.
- Comprehensive knowledge of clinical coding, medical necessity and case-management practices relevant to claims and network management.
- Strong ability to translate clinical standards into measurable cost-containment and customer-experience outcomes.
- Extensive external network across hospitals, providers and clinical partners in Asia.
Skills
Compliance
