Medical Provider Management Specialist (Major Medical Expenses)

Location: Mexico City, Mexico — onsite in the south of the city at Torre Manacar

Salary: 30,000–40,000 MXN per month, commensurate with experience

Contract term: 18 months

Company

hirify.global provides on-demand talent, consulting, and outsourced services through a global network of more than 2,600 experts across four regions.

What you will do

• Manage the full lifecycle of hospitals, physicians, oncology centers, diagnostic centers, and other medical providers, including prospecting, onboarding, credentialing, renewals, modifications, and terminations.
• Negotiate rate schedules, package deals, discounts, and payment terms with healthcare providers.
• Perform cost variance analysis, rate benchmarking, and medical expense reviews across specialties, regions, and service types.
• Coordinate with Provider Management, Claims, Direct Payment, Treasury, Legal, and Product teams to resolve billing, authorization, and payment issues.
• Maintain validated legal, tax, banking, and professional credentials in provider files with audit-ready traceability.
• Track SLA compliance, average cost, claims frequency, and utilization, using data-driven and AI-supported insights to optimize network strategy.

Requirements

• Bachelor’s degree in Business Administration, Finance, Economics, Actuarial Science, Health or Hospital Administration, Engineering, or a related field.
• Professional English proficiency is required.
• At least 3 years of experience in medical provider management, medical network operations, GMM claims, direct payment, or hospital agreement administration.
• Experience with commercial negotiation, rate structure analysis, and contract administration in private healthcare or insurance.
• Experience analyzing claims data, preferred networks, and medical cost-containment strategies.

Nice to have

• Certifications in healthcare administration, insurance, negotiation, or financial analysis.

Culture & Benefits

• Medical, dental, vision, life, and disability insurance.
• 401(k) savings plan and employee stock purchase plan.
• Professional development program.
• Paid time off and paid sick time where legally required.
• Focus on continuous learning, human-centered design, advanced technology, and collaborative work.