CAREERS

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Vacancies

The Medical Provider Manager is responsible to efficiently and effectively manage the Medical Provider network as per the defined network strategy, pricing models in line with Medical Provider management processes. The Medical Provider Manager is expected to negotiate strategically with the Medical Providers with an objective to procure healthcare services at an optimized cost and to generate value, through effective negotiations and execution of identified strategies. 

Egypt
International Health- Medical Provider Management
Key Responsibilities:
  • Collaboration with local Business unit to deliver network requirements locally
  • Manage the team of Medical Provider Management resources locally, where applicable
  • Alignment with Regional and Central Medical Provider Management functional strategy and support teams
  • Manages negotiations with Medical Providers per defined pricing model per network category to reduce average claim cost per network
  • Ownership and Accountability for the delivery of assigned components of the regional MPM Strategy, including, but not limited to: Consolidation, Integration, Maintenance & Development of Medical Provider Network in the Region as well as Cost Containment & Financial Savings impact
  • Guarantee Medical Provider Management business continuity, efficiency and service levels within the region: Performance monitoring and assessments of Medical Providers in terms of delivery, quality and efficiency
  • Actively contribute to the retention and growth for local and global LOBs where relevant
  • Develop, Align and execute Strategic network management plans for the region
  • Conduct regional and local Medical Provider Network capacity
  • Provide regional and local Medical provider cost analysis
  • Support Global lines and BUs within region in maintenance and development of business opportunities
  • Within the region, perform evaluations, performance appraisals and dismissals in line with local HR standards/ processes and local legal management and in alignment with Head of Medical Provider Management. Where applicable.
Key and Profile Requirements:
  • Maintains and updates the existing Medical Provider contract agreement records in alignment with Company legal and compliance policy
  • Develops methods, strategies, and tools to improve provider relationships
  • Enhances the volume-rebate structure to generate savings as applicable in regions per local mandates
  • Manages team to achieve financial savings and factually demonstrate the same for individual target as well as team targets
  • Manages and ensures generation of Periodic Dashboards to evaluate and monitor claim cost, identify the utilization trends & variances and negotiate with Medical Providers to reduce the claim cost per Network
  • Bares primary responsibility of maintaining valid Medical Provider contractual agreements and updated database
  • Action tariff revision requests from existing Medical providers as per the Medical Provider Management policy and guidelines
  • Acquires medical services in accordance with Medical Provider Management operating Model and manage empanelment request from Medical Providers to provide comprehensive network at an optimized cost
  • Performs post contract evaluations, create and maintains records
  • Organizes and conduct Medical provider trainings periodically as defined in Medical provider management operating model
  • Manages the negotiation of Gate keeper arrangements special schemes arrangements with Medical providers with specification of SLA
  • Participates in specialized projects and assignments related to Medical provider management function as required
  • Uses judgment, diplomacy and confidentiality with respect to the complete Medical Provider Man
  • Bachelor’s / Master’s Degree; Medical background preferred (Pharmacy/ Medicine and Surgery)
  • 5+ years’ experience in a supervisory role in a network administration environment (preferably gained in hospitals, insurance companies, TPAs)
  • Experience managing remote teams across multiple locations
  • Experience managing in multinational, blue chip organisation
  • Legally permitted to work in the country of operations
  • Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills
  • Expertise in general industry trends and excellent negotiation skills
  • Strong interpersonal/relationship skills
  • Ability to analyze data and interpret results
  • Excellent verbal and written communication skills
  • Ability to maintain confidentiality and respect through all correspondences
  • High level of dependability, accountability and integrity
  • Ability to adapt to change, meet the changing demands of work environment, any delays or other unexpected demands
  • Ability to treat people with respect under all circumstances, instill trust in others besides upholding the values of organization
  • Capable of perceiving the problems as they develop and communicating such to their immediate supervisor
  • Expertise to collaborate and work with internal and external colleagues to successfully complete the defined tasks and provide superior customer service
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