The TPA Manager holds end-to-end accountability for the TPA operating model, ensuring alignment with health business growth, profitability, customer experience, and risk management. The role is positioned as a strategic advisor to senior leadership on vendor strategy and operating model design. The TPA Manager is accountable for delivering exceptional service to customers and distribution partners by managing the relationship and performance of the Third-Party Administrator (TPA) responsible for health insurance claims for Manulife policyholders. The role ensures efficient claims processing, regulatory compliance, and superior customer experience, contributing significantly to the company’s strategy of becoming the preferred choice for customers in the Philippines. Position Responsibilities: Develop and implement TPA strategies aligned with the company’s health business objectives. Drive transformation initiatives to enhance customer experience within the TPA’s scope of work. Define and monitor KPIs, including SLAs for in-scope transactions, complaint handling, First Call Resolution (FCR), Net Promoter Score (NPS), and metrics related to fraud, waste, and abuse. Establish the strategy for an in-house provider network, as applicable. Lead the TPA selection process, including evaluation of RFP responses, system demonstrations, site visits, reference checks, and contract negotiations. Manage and oversee TPA operations for both claims and contact center, ensuring compliance with SOPs, monitoring TAT, resolving complex issues, and escalating risks within 24 hours. Review and report financial and non-financial errors by the TPA on a weekly and monthly basis in collaboration with the Health Claims Team. Facilitate Monthly TPA Steering Committee meetings to review challenges, identify improvement areas, and propose solutions. Assist in building an in-house provider network, including recruitment, credentialing, contracting, and onboarding, as required. Provide oversight of high-volume, business critical claims and contact center operations with accountability for service continuity and reputational risk. Balance service quality with cost-to-serve optimization. Establish and maintain quality assurance processes and reporting to ensure service excellence. Collaborate with the TPA to drive adoption of AI-powered technologies, automation, chatbots, and analytics tools to enhance service and process quality. Partner with other divisions to ensure robust infrastructure and deliver faster, simpler, and better solutions for customers and distribution. Train and develop a high-performing TPA team. Lead internal staff supporting TPA operations, providing training on claims and vendor management processes. Foster a culture of continuous improvement, accountability, and customer empathy. Ensure that performance management and capability building mechanisms are implemented by the TPA. Implement career development and succession planning for key roles. Manage the revolving fund and ensure accurate billing and reconciliation of paid claims and TPA fees. Own TPA-related budgets and ensure adherence to the budget for staffing, technology, and operations. Ensure adherence to internal policies and external regulatory requirements. Manage fraud and regulatory risk in line with enterprise standards. Work closely with Underwriting, Claims, Distribution, Marketing, Product, and other relevant teams and act as an integrator across these teams to ensure seamless customer and distribution journeys. Support digital transformation initiatives and enable customer/agent self-service. Analyze feedback and trends to identify service gaps and training needs. Promote a customer-first culture across the TPA team. Own TPA‑driven customer outcomes (e.g., NPS, complaints, FCR) and drive sustained service and process improvements. Required Qualifications: University graduate with at least 5 years of solid experience in TPA management, preferably within the insurance industry. Knowledge of hospital and/or TPA operations is an advantage. Familiarity with the latest technological developments, trends, and standards is desirable. Highly motivated and capable of working independently and collaboratively. Proven ability to build and lead high-performance teams within operations and support functions. Strong analytical and problem-solving skills; comfortable with numerical analysis. Excellent report writing skills and ability to present data effectively to senior management. Strong collaboration and interpersonal communication skills. Demonstrated ability in team management, coaching, mentoring, and people development. Strong stakeholder management skills, including interaction with regional functions. When you join our team: We’ll empower you to learn and grow the career you want. We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words. As part of our global team, we’ll support you in shaping the future you want to see.マニュライフとジョン・ハンコックについてマニュライフ・ファイナンシャル・コーポレーションは、「あなたの未来に、わかりやすさを」を提供する、国際的な大手金融サービスプロバイダーです。当社について詳しくは、 https://www.manulife.co.jp/をご覧ください。マニュライフは機会均等を是とする雇用主ですマニュライフ/ジョン・ハンコックでは、多様性を受け入れます。私たちは、サービス提供先であるお客さまと同様に、多様な人材を引きつけ、育成し、定着させ、文化や個人の力を受け入れる包括的な職場環境を促進するよう努めています。当社は公正な採用、定着、昇進、報酬に努めています。当社のすべての慣行およびプログラムは、人種、祖先、出身地、肌の色、民族的出自、市民権、宗教または宗教的信念、信条、性別（妊娠および妊娠関連の状態を含む）、性的指向、遺伝的特徴、退役軍人としての地位、性自認、性に関する表明、年齢、婚姻状況、家族状況、障害、または適用法で保護されるその他の要因に対する一切の差別を行うことなく管理されます。雇用への平等なアクセスを提供するために、障壁を取り除くことが当社の優先事項です。人事担当者は、応募者が応募プロセス中に合理的配慮を要求する場合に協力します。配慮要求のプロセス中に共有されるすべての情報は、適用される法律およびマニュライフ/ジョン・ハンコックのポリシーに準拠した方法で保存および使用されます。申請プロセスにおいて合理的配慮を要求するには、hr@manulife.comまでご連絡をお願いします。Working Arrangementハイブリッド勤務
