Advisory Director - HMO Operations

Advisory Director – HMO Operations Details:

• Location: Las Pinas City
• Employment Type: Consultancy
• Start Date: Immediate Who we are: A recruitment agency with integrity. At Strata Results Recruitment, we’re a committed team of recruitment professionals, dedicated to helping our clients find the right people to achieve success. We work with small and large companies, across a broad range of industries, recruiting for roles across a range of disciplines and levels. Our business is built on our core values of honesty, integrity, transparency, and hard work. We are invested in the success of our clients and will be with you every step of the way when it comes to recruiting the right people for your business! Our experience spans across many industries which include Telecommunications, Government, Information Technology, Manufacturing, Casino and Gaming, Hospitality, Transport & Logistics, Construction, Humanitarian, and Banking.

What we are looking for

We are seeking a highly experienced Advisory Director – HMO Operations (Consultant) to provide strategic guidance and expert advice on optimizing HMO operations within a healthcare organization. This leadership role focuses on strengthening operational efficiency, governance, compliance, and process improvement while supporting executive management in achieving organizational objectives.

The ideal candidate has extensive experience in hospital operations and HMO management, with a deep understanding of Philippine healthcare regulations, accreditation standards, and operational best practices. This is an advisory role and does not involve direct responsibility for HMO contract negotiations or partnership management.

Key Responsibilities

Strategic Advisory Provide expert guidance on HMO operations, including authorization, claims processing, billing, and reimbursement workflows. Recommend policies, frameworks, and best practices to improve operational efficiency and patient experience. Advise management on industry trends, regulatory developments, and risk mitigation strategies.

Align HMO operational strategies with the hospital's overall business objectives. Compliance & Governance Ensure HMO processes comply with Philippine healthcare regulations and accreditation standards. Review and recommend improvements to internal policies and procedures related to HMO operations. Support compliance initiatives, governance programs, and audit readiness.

Provide advisory support during accreditation reviews and regulatory assessments. Performance & Process Improvement Analyze operational data and identify opportunities for process optimization. Recommend technology solutions, automation initiatives, and data-driven improvements. Establish and monitor key performance indicators (KPIs) and reporting standards.

Promote continuous improvement across HMO-related operations. Executive & Stakeholder Advisory Collaborate with hospital executives and department heads on strategic HMO initiatives. Attend Presidential Executive Board meetings and provide expert recommendations. Evaluate the performance of the General Manager and provide strategic feedback.

Represent the organization in advisory forums, industry discussions, and executive-level meetings when required.

Qualifications

Master's degree in Healthcare Administration, Business Administration, or a related field (MBA preferred). Minimum 10 years of experience in healthcare operations with extensive expertise in HMO processes. Strong knowledge of Philippine HMO regulations, hospital operations, and accreditation standards. Demonstrated experience in providing strategic advisory services and leading operational improvements.

Excellent analytical, leadership, communication, and executive presentation skills. Key Skills and Competencies: Strategic planning and business acumen Expertise in HMO operations and healthcare regulations Governance, compliance, and risk management Data analysis and process improvement Executive leadership and stakeholder management Strong communication, influencing, and presentation skills Decision-making and problem-solving abilities