Provider Contract Executive
- To support the Provider Network Development Managers in Healthcare management in developing, improving and maintaining Bupa Global’s network of providers in Egypt.
- To support research into the relevant approach for the market: direct contracting, hospital network access, cost management and to support delivery of the recommended approach, through to contract compliance and governance.
- To support a portfolio of providers / geographical areas delivering strong network position and cost management through direct contracting or relationships with external partners and correspondents
- To continually develop, improve and maintain Bupa’s network of providers delivering a differentiated service proposition for customers and providers, quality of care and cost management.
- To support the development of on-line functionality, web positioning, and other collateral to drive a superior offering to providers
- To maintain and deliver existing and future databases, and standardised best practice models to support the strategy and management of BG’s provider network.
- To represent Healthcare management in cross functional business projects, initiatives and processes.
- To develop and enable delivery of the internal and external Healthcare Services provider management communication strategy and knowledge sharing.
- To liaise with internal stakeholders in a range of departments to enable first class provider management through collation of operational and financial performance material, including clinical audit findings, and quality performance measures to support contract renewals and ongoing provider performance management.
- To support the implementation, development and maintenance of Bupa Global’s provider management strategy for the region, ensuring alignment with Bupa Global’s proposition development, sales and service agenda.
- Achieve personal targets and develop pipeline for future activity.
- Research availability and quality of healthcare provision in target markets and recommend appropriate purchasing and claims spend management approach, being direct contracting, network access agreement, cost management arrangements through third parties or product structure and policy application rules. Negotiate and oversee negotiations of contracts with providers to enable access to healthcare, delivering financial and commercial advantage through best price and quality care for our customers. Delivery should be in conjunction with sales, marketing, finance and operational areas of the business to ensure effective implementation and management.
- Support management of provider relationships ensuring delivery of high quality, customer focussed and cost effective healthcare to all Bupa Global members. Ensure that relevant records reflect up to date communications with providers facilitating prompt resolution of enquiries / issues. Act as point of referral for escalated queries.
- Within target markets, review and regularly monitor Bupa Global’s claim spend and procedures, and provider behaviour to ensure that opportunities for additional claims spend management are highlighted. Ensure results are incorporated into quarterly provider or partner review processes, and / or annual renewal processes.
- Within target markets, support the definition and execution of strategies to extend provider coverage e.g. to build doctors’ networks with agreed discounts and direct settlement, or other inpatient / outpatient direct settlement arrangements. Support the development of speciality networks as required.
- Collaborate with other teams within Health and Benefits to contribute to development of operational processes, and to monitor operational and financial performance of BG’s provider network
- Contribute to development of regular reports around provider management activity.
- Understand, comply with and abide by the regulatory requirements of relevant markets within the region including, but not limited to, the Financial Services Authority (FSA) and Financial Ombudsman Service (FOS).
The Ideal Candidate
- Previous experience, preferably in private medical insurance or negotiation.
- Perfect command of English, both written and verbal. Other languages would be an advantage.
- Strong commercial knowledge of the health insurance industry
- Good commercial negotiation skills, able to deal with high level hospital administrators but also at operational management level.
- Ability to deliver projects on time, budget and within agreed quality.
- Proven track record of achieving targets with a consistent high level of quality.
- Ability to work under pressure in a fast paced environment.
- Ability to influence business areas without having direct management responsibility.
About the Company
We are a health insurer and provider. With no shareholders, our customers are our focus. We reinvest profits into providing more and better healthcare for the benefit of current and future customers.
Bupa’s purpose is longer, healthier, happier lives.
Here you’ll be welcomed. We champion diversity and we understand the importance of our people representing the communities and customers we serve. You’ll find an inclusive environment where you can be yourself and where everyone is driven by the same purpose – helping people live longer, healthier, happier lives.
Bupa Global is the international health insurance division of Bupa. We provide customers who want premium international coverage with products and services to access the healthcare they need anytime, anywhere in the world, whether at home or when studying, living, travelling or working abroad.
Bupa Global has offices around the world including London and Brighton (UK), Miami (USA), Copenhagen (Denmark), Dubai (UAE, in partnership with OIC), and Hong Kong (China) as well as regional offices in mainland China, Singapore, Egypt, Mexico, the Dominican Republic, Bolivia, Brazil, Panama, Guatemala and Ecuador.
Timescales for reviewing applications will differ between regions, but you will always receive a response to your application. The recruitment process itself will vary per role and region, but you will be updated along the way via phone and email (so please look out for these!). To view what stage of the process your application is currently at, you can also log in and view your dashboard.
If you are invited to an interview, a member of the resourcing team will be able to advise you on what to expect. This will vary in region, but will likely include an initial phone or digital interview, followed by one or more of the following depending on the role: Core capability interview; Technical/function specific interview; Online profiling assessment; Presentation, written task, role play; Assessment centre.
If your application is successful and you’re invited to join the team, the resourcing team will guide you through your on boarding journey.
Should you require any reasonable adjustments to be made or facilities provided to enable you to attend an interview, please do not hesitate to contact us prior to the interview at email@example.com, so we can make adjustments accordingly.