Job Description
The job holder is responsible to assist the Team Leader- Provider Contracting and Network Manager in the development of the healthcare service provider network, in line with the business plan.
Key accountabilities;
- Identify sub-categories of providers and preferred providers through Provider Profiling analysis, to create distinctive network advantages for MedNet
- Be responsible for the contracting and re - contracting process and negotiate with the healthcare service providers within corporate guidelines to ensure all services provided are cost effective and in accord with quality standards
- Conduct presentations and trainings for appointed healthcare provider staff on managed care concepts and provide updates on all related procedures in order to ensure awareness of MedNet service requirements and policies across the network
- Review policy manual and network agreements on an on-going basis and provide suitable recommendations
- Support the Team Leader / Manager in the implementation of quality assurance programs in order to maintain standards of quality and minimize fraudulent cases
- Develop and maintain monthly statistical reports to facilitate benchmarking and performance management of network operations for management decision-making
- Update MedNeXt with data relating to addresses, discounts, creation of new codes, specialties, etc. on a periodic basis
- Prepare quarterly network newsletters intended for insured members, insurance companies and intermediaries
To Qualify:
Diploma or Bachelor Degree in Medicine, Hospital Administration, related healthcare sciences (Physiotherapy, Nursing, Radiology or Laboratory technician) or similar qualification
2 - 3 years of experience in a provider contracting role in TPA / medical insurance sector preferably in the Gulf region
Good interpersonal skills and ability to communicate clearly and effectively with internal and external clients across all levels, with fluency in business English (written and spoken); Arabic would be an advantage
UAE Driving License is mandatory
Industry knowledge related to local healthcare services system will be an added advantage
