National Health Insurance Company – Daman

Senior Officer, International Provider Relations (BB-0268D)

Found in: Neuvoo Premium AE


Job Role: Senior Officer, InternationalProvider Relations


General Description

  • Perform required negotiations and contractingprocedures for prospective and existing international providers;manage assigned provider portfolio and provide orientation,education and perform routine visits to ensure compliance withDaman policies and procedures and gather marketintelligence.

Main Duties

  • Serve as the primary point-of-contact for assigned Damannetwork providers
  • Define and execute mostappropriate network access and cost containment strategy within theallocated regions
  • Build and nurture positiverelationships with existing and potential providers
  • Complete negotiations with new and existing providers tobuild a strong, sustainable network to meet Daman'sfinancial targets
  • Review and revise assignedproviders' contracts, and ensures that all necessarydocumentation is complete, current and correct
  • Routinely perform financial analysis related to assignedproviders' contracts
  • Evaluate and/ormonitor assigned providers' contract performance todetermine, the necessity for amendments (i.e. price revisions,additional services, etc.) or extensions of contracts andcompliance to contractual obligations
  • Analyseand recommend price proposals, analyse financial reports, and otherdata to determine reasonableness of contracts
  • Identify opportunities for renegotiation of contracts andperform analysis to realize department objectives (i.e. pricerevisions, cost containment, initiatives, labinitiative)
  • Monitor network providerperformance through scheduled site visits and data analysis (i.e.physical facilities, staff customer interaction, clinicalperformance, checking of provider KPIs, challenges of providers todetermine how to improve further support the providers,etc.)
  • Review provider dashboards and qualityreports to measure provider performance and utilization andevaluate, identify or respond to anomalies in utilization trends,service gaps and service needs related to provider questions andconcerns
  • Undertake projects related to,expansion and strategic NW activities in existing markets;coordinate with the different medical department in theimplementation of the initiatives (training and informationdissemination to providers)
  • Representdepartment in client and broker meetings

Work ExperienceRequirements

  • Minimum4 years of health insurance, healthcare provider or TPA experience;2 year of which must be as Provider Relations Officer or anyequivalent position
  • Minimum 2 years ofexperience in negotiating and contracting with medicalproviders
  • Experience working withinternational healthcare providers and/or TPAs is a must

calendar_today2 days ago

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location_onAbu Dhabi, United Arab Emirates

work National Health Insurance Company – Daman

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