ROLE PURPOSE:
To accomplish contract administration, pricing & cost effectiveness and network design of the providers through the implementation of the agreed department action plans to achieve quality, accessible and affordable healthcare within the agreed timescales.
KEY ACCOUNTABILITIES:
1. Contract Administration
• Implement the set of contracts’ uniformity and standards with all providers.
• Execute contracting new providers ,new service codes and the renewal of contracts in accordance with applicable guidelines and instructions.
• Maintain contracts’ compliance with the regulatory, renewals and licensing requirements.
• Follow up contracting administration to ensure timely processing and finalization.
2. Benchmarking
• Engage in the Identifying of frequently billed items according to providers distribution.
• Collect price range for each frequent item per network according to providers distribution.
• Collect prices/quotations for other items/services whenever needed (experienced) or requested.
• Support other business units in pricing services and items.
• Apply standard optical and dental pricing models.
• Implement the benchmarks and related guidelines in the providers’ agreements and pricing.
3. Pricing,Discounts and Codings
• Implement the revamped coding systems.
• Resolve the defaults of the invalid & duplicate service codes and overbilling with the assigned providers.
• Coordinate, internally and externally, for the resolution of coding and pricing defaults.
• Engage in business obligations of ICD 10-am implementation.
• Ensure that new prices,contracts and amendments are uploaded in the operating systems.
• Ensure the implementation of discounts,PPD and volume discounts.
4. Cost Effectiveness
• Identify items potential areas for price reductions to achieve business targets with the assigned providers.
• Identify providers and services’ potential for bundling(in & out patients) and expansion of surgical packages.
• Negotiating price reductions and bundling with the assigned providers.
• Conduct studies for the financial impacts of proposal and agreements of new contracts/service codes and renewals.
5. Network Design and management
• Identify areas for potential network redesign to achieve business objectives of affordable care.
6. Volume Allocation
• Monitor the implementation of stepladder and referral systems with regular updates to achieve best practice and cost effectiveness.
• Identify providers fitting network of anchors and centers of excellence.
• Engage in building partner relationship with strategic providers.
7. Coordination and Communications
• Coordinate with the operating team and technical stakeholders to ensure the implementation of addition /deletion of contracts/providers,amendments and significant contract milestone .
• Coordinate with provider relation and stakeholders targets & plans of negotiation.
تفاصيل الوظيفة
| 2015-04-05 | تاريخ الإعلان عنها: |
| جدة, المملكة العربية السعودية | منطقة الوظيفة: |
| غيرذلك | الدور الوظيفي: |
| صحة عامة/غير ذلك | قطاع الشركة: |
المرشح المفضل
| إدارة | المستوى المهني: |
| بكالوريوس | الشهادة: |
تقدم الآن - وظائف في السعودية - وظائف في جدة, المملكة العربية السعودية - وظائف في الرياض, المملكة العربية السعودية - وظائف غيرذلك في السعودية - بحث عن جميع الوظائف
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