Location: Cork (with national travel) Department: Claims & Provider Relations Reporting to: Director of Claims & Provider Relations
About Us
At laya healthcare, we are committed to helping people live longer, healthier lives. As one of Ireland’s leading health insurers, we combine deep clinical expertise with a strong focus on innovation, quality, and member experience to deliver better healthcare outcomes.
We are currently at an exciting stage in our evolution, with a strong focus on enhancing how we deliver care, strengthening clinical governance, and collaborating more effectively with healthcare providers. This is a unique opportunity to join a forward‑thinking organisation and play a key role in shaping the future of healthcare delivery for our members.
About the Role
We are seeking an experienced and commercially aware clinical leader to join our senior management team as Head of Clinical Office.
This role will provide strategic clinical leadership across the organisation, ensuring high standards of patient care, strong clinical governance, and effective collaboration with healthcare providers. You will play a key role in shaping how we deliver value‑based healthcare outcomes while supporting the ongoing evolution of our clinical and reimbursement frameworks.
Key Responsibilities
Clinical Leadership & Strategy
Provide expert clinical guidance to support business decision‑making
Contribute to the development and delivery of key clinical and operational initiatives
Drive improvements in patient outcomes, clinical quality, and cost effectiveness
Governance & Oversight
Lead clinical governance frameworks to ensure safe, effective, and evidence‑based care
Oversee clinical aspects of claims adjudication, appeals, and complex case reviews
Support the development of clinical policies, guidelines, and best practice standards
Provider & Stakeholder Engagement
Build and maintain strong relationships with consultants, hospitals, and healthcare partners
Represent the organisation in clinical and reimbursement discussions
Support the evolution of provider engagement approaches
Innovation & Evaluation
Assess new medical procedures, technologies, and treatments
Contribute to the development of sustainable and future‑focused healthcare solutions
Promote evidence‑based practice and continuous improvement
Leadership & People Management
Lead and develop a multidisciplinary clinical team
Foster a culture of collaboration, accountability, and high performance
Support capability development and succession planning
Commercial & Operational Contribution
Contribute to financial sustainability through effective clinical input
Support the refinement of reimbursement and benefit structures
Oversee budget management within the clinical function
About You
Qualifications
Medical degree (MB, BCh or equivalent) with current Medical Council registration
Minimum 10 years’ post‑qualification clinical experience
Relevant postgraduate qualification (e.g. MICGP, MRCPI or equivalent)
Experience & Skills
Proven experience operating at senior leadership level
Strong clinical credibility with the ability to influence at executive level
Experience working within complex healthcare environments
Commercial awareness and understanding of healthcare delivery models
Excellent stakeholder management and communication skills
Strategic thinker with a solutions‑focused mindset
Desirable
Experience within private healthcare or health insurance
Exposure to large‑scale clinical or operational transformation
Why Join Us
This is a unique opportunity to shape the future of clinical leadership within a dynamic and evolving healthcare environment. You will play a critical role in delivering high‑quality, sustainable healthcare outcomes while working as part of a collaborative and forward‑thinking senior leadership team.
#J-18808-Ljbffr