Manager – PR Contract Management

<div><p>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</p><h3>Contract Administration:</h3><ul><li>Implement the set of contracts’uniformity and standards with all providers.</li><li>Excute contracting new providers ,new service codes and the renewal of contracts in accordance with applicable guidelines and instructions</li><li>Maintain contracts’ compliance with the regulatory, renewals and licensing requirements</li><li>Follow up contracting administration to ensure timely processing and finalization</li></ul><h3>Benchmarking:</h3><ul><li>Engage in the Identifying of frequently billed items according to providers distribution</li><li>Collect price range for each frequent item per network according to providers distribution</li><li>Collect prices/quotations for other items/services whenever needed (experienced) or requested.</li><li>Support other business units in pricing services and items</li><li>Apply standard optical and dental pricing models.</li><li>Implement the benchmarks and related guidelines in the providers’ agreements and pricing</li></ul><h3>Pricing ,Discounts and Codings:</h3><ul><li>Implement the revamped coding systems</li><li>Resolve the defaults of the invalid&duplicate service codes and overbilling with the assigned providers</li><li>Coordinate, internally and externally, for the resolution of coding and pricing defaults.</li><li>Engage in business obligations of ICD 10-am implementation</li><li>Ensure that new prices ,contractsand amendments are uploaded in the operating systems.</li><li>Ensure the implementation of discounts ,PPD and volume discounts</li></ul><h3>Cost Effectiveness:</h3><ul><li>Identify items potential areas for price reductions to achieve business targets with the assigned providers</li><li>Identifyproviders andservices’ potential for bundling(in&out patients) and expansion of surgical packages</li><li>Negotiating price reductions and bundling with the assigned providers</li><li>Conduct studies for the financial impacts of proposal and agreements of new contracts/service codes and renewals</li></ul><h3>Network Design and management:</h3><ul><li>Identify areas for potential network redesign to achieve business objectives of affordable care.</li></ul><h3>Volume Allocation:</h3><ul><li>Monitor the implementation of stepladder and referral systems with regular updates to achieve best practice and cost effectiveness.</li><li>Identify providers fittingnetwork of anchors and centers of excellence</li><li>Engage in building partner relationship with strategic providers</li></ul><h3>Coordination and Communications:</h3><ul><li>Coordinate with the operating team and technical stakeholders to ensure the implementation of addition /deletion ofcontracts/providers ,amendments and significant contract milestone .</li><li>Coordinate with provider relation and stakeholders targets&plans of negotiation.</li></ul></div>#J-18808-Ljbffr