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.
About Manulife and John Hancock
Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit https://www.manulife.com/en/about/our-story.html.
Manulife is an Equal Opportunity Employer
At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.
It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact hr@manulife.com.
Working Arrangement