Senior Healthcare Network Procurement & Data Manager

Job Purpose

People Management

• Manage allocated direct reports to deliver business goals.
• Recruit, develop, train, evaluate, and coach staff supporting network management and administration.
• Manage workload and resources to maintain appropriate staffing and team performance.

Network Management

• Lead annual proactive and reactive provider negotiations and contracting activity.
• Manage network administration and contract database processes.
• Implement discounts, rebates, and contractual terms and collect agreed amounts.
• Lead cost containment initiatives and conduct provider allocation studies based on risk and cost.
• Identify potential price reductions with assigned providers.

Network Development

• Identify network development opportunities based on stakeholder requirements and sales team input.
• Lead market analyses and competitor network research.
• Manage the end-to-end provider empanelment process.
• Monitor provider network coverage and identify new contracting opportunities.

Network Data Management

• Maintain benchmarking for provider prices and competitor networks through internal and market analyses.
• Design and implement provider quality controls, profile audits, data quality assurance, and tariff audits.
• Analyze provider utilization, price lists, and billing trends to support negotiations.
• Calculate and analyze financial impacts of new contracts, service codes, and renewals.

Governance and Projects

• Deliver reporting on negotiations, contracting activity, recoveries, rebates, and network activity.
• Liaise with compliance and legal teams on regulatory requirements.
• Represent healthcare network management on cost containment projects.
• Lead regulatory system changes and communications with providers and vendors.
• Lead negotiations on savings from regulatory coding and billing mandates.

Role Requirements

• Extensive knowledge of healthcare insurance in GCC countries.
• Expert knowledge of GCC legislation and regulations.
• Extensive connections with healthcare providers in GCC countries.
• At least five years of experience in a similar position.

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