Senior Executive Manager – PR Operations
Bupa Arabia
Date: 1 day ago
City: Riyadh
Contract type: Full time
Job Description
Role Purpose:
To manage the commercial and contractual relationship with Bupa network providers to ensure compliance with regulators to deliver business benefits.
Key Accountabilities:
1- Reconciliation of the accounts;
Role Purpose:
To manage the commercial and contractual relationship with Bupa network providers to ensure compliance with regulators to deliver business benefits.
Key Accountabilities:
1- Reconciliation of the accounts;
- Analyze and monitor the cost effectiveness of the unit and utilization of provider services for better control.
- Plan reconciliation meetings including scheduled meetings, coordination with medical manager, preparation of financial figures and negotiation.
- Negotiate the reconciliation with the providers to achieve the set targets
- Document the reconciliation points and send feedback to the claims department and regional manager.
- Support in the preparation of presentations to the owners of top 20 providers to highlight trends and errors.
- Ensure that the reconciliation is conducted on regular basis and in line with CCHI regulations
- Maintain existing and renewed contracts to identify and resolve issues to enhance commercial terms and improve operations.
- Establish good relationship with new providers and assess the integration for Bupa network by comparing their prices in network hospitals taking into consideration the providers’ location and the geographic distribution of the members.
- Enhance the commercial trading terms by negotiating and signing up improved prices and discounts to guarantee that Bupa will achieve the price reduction targets set annually.
- Prepare the proposals for improved prices and discount structures of the frequent services and packages in coordination with the commecial team and medical managers.
- Negotiate and agree with the providers on the improved prices to help score better deals for the identified high value claims on real time basis.
- Communicate the agreements to the commercial and support team for uploading and implementation.
- Monitor the compliance of the providers with the agreements on their claims statements.
- Plan and carry regular visits to the providers in order to maintain professional relationships.
- Support in following up on issues raised during negotiation with providers.
- Identify the critical trends in medical practice of service providers
- Manage the delivery of training sessions and development programs of providers’ staff on new Bupa systems, policies and procedures.
- Maintain relations with other medical teams in the business including the hospital claims integrity team.
- Experience in Providers Network Management
- Analytical skills
- Negotiation and communication skills
- Planning and organizational skills
- MBBS is a plus
How to apply
To apply for this job you need to authorize on our website. If you don't have an account yet, please register.
Post a resumeSimilar jobs
Operations Manager - CAF (Construcciones y Auxiliar de Ferrocarriles)
Echelonix,
Riyadh
3 hours ago
JOB PURPOSE:The Operational Manager has to drive and encourage multitude of areas.Key roles and responsibilities of the position:Follow up of the Warranty and Maintenance Center. Achieving the contractual and internal objectives of the project. Support Project Manager / Branch in the organization of the workshop.Main Functions are: Planning of labor and materials.Planning milestones, monitoring and carrying out the objectives.Technical and...
ICQA Researcher, ICQA
Afaq - Warehouse Branch,
Riyadh
1 day ago
Proficiency with Microsoft Excel to include making charts, data manipulation, creating up macros, and visual basic knowledge
UNIX tools/platform experience • Experience using HTML, PERL, SQL, Ruby, Java, AJAX programming languages
Experience with Oracle
The Data and Reporting Analyst (Support Team) will work closely with the Inbound, Outbound, and Inventory Control operations to develop tools and analyze data to support...
E T Consultant - PPP (Senior) Investment Support
World Bank Group,
Riyadh
1 day ago
E T Consultant - PPP (Senior) Investment Support Job #: req30779 Organization: IFC Sector: Infrastructure Grade: EC3 Term Duration: 1 year 0 months Recruitment Type: Local Recruitment Location: Riyadh,Saudi Arabia Required Language(s): English Preferred Language(s): Arabic Closing Date: 1/2/2025 (MM/DD/YYYY) at 11:59pm UTC Description IFC - a member of the World Bank Group - is the largest global development institution...