Provider Contract Executive at Bupa

Cairo, Cairo, Egypt -

Full Time

Start Date

Immediate

Expiry Date

04 May, 26

Salary

0.0

Posted On

03 Feb, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Negotiation, Healthcare Management, Provider Relationships, Claims Management, Cost Management, Commercial Knowledge, Project Delivery, Pressure Management, Influencing, Research, Communication, Reporting, Regulatory Compliance, Service Improvement, Network Development, Quality Care

Industry

Insurance

Description

Job Description: Provider Contract Executive District 5 Campus, Building B07, Ain Sokhna Road, New Cairo 11361, Cairo, Egypt Bupa Egypt Insurance SAE Full Time Fixed Term (40 hours per week) Hybrid Working We make health happen 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, around 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), Dublin (Europe), Miami (USA), Dubai (UAE, in partnership with OIC), Egypt and Hong Kong (China) as well as regional offices in mainland China, Singapore, the Dominican Republic, Bolivia, Panama, Guatemala and Ecuador. To support the TPA and Network Development managers in Healthcare management in developing, improving and maintaining Bupa Globals network of providers in Egypt. You will be supporting research into the relevant approach for the market: direct contracting, hospital network access, cost management through Third party administrators or other third-party arrangements, and to support delivery of the recommended approach, through to contract compliance and governance. You will support a portfolio of providers / geographical areas delivering strong network position and cost management through direct contracting or relationships with external partners. You will continually develop, improve and maintain Bupa’s network of providers delivering a differentiated service proposition for customers and providers, quality care and cost management How you’ll help us make health happen What you'll do: Prepare and recommend negotiation plans and terms of reference for interaction with third parties in relation to network access and outsourced claims management arrangements. These approaches must be agreed with the Provider Network Development managers and where appropriate the Head of Healthcare management, before negotiating activities commence. Act as point of referral for provider queries. 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 of quality healthcare provision in target markets and recommend appropriate purchasing and claims spend management approaches, through direct contracting, network access agreements, cost management arrangements through third parties or product structure and policy application rules. 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. Within target markets, review and regularly monitor Bupa Global’s claim spend, 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 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 Healthcare Management to contribute to the 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). • Conduct ongoing evaluation of relationships through regular meetings and identify opportunities for improvement of service and commercial advantage (value for money). • In conjunction with other members of HCM review and regularly monitor Bupa Global’s claim spend in allocated markets to ensure that opportunities for additional claims spend management are highlighted. • Interface with other teams in HCM to ensure that terms and conditions agreed with our service partners and provider network can be implemented and delivered effectively. Obtain feedback and recommendations from our network partners and disseminate this information within Bupa Global What you'll need: Bachelor’s degree or above 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 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 Benefits Our benefits are designed to make health happen for our people. Viva is our global wellbeing programme and includes all aspects of our health – from mental and physical, to financial, social and environmental wellbeing. We support flexible working and have a range of family friendly benefits. Joining Bupa in this role you will receive the following benefits and more: Egypt Specific Benefits Why Bupa? We’re a health insurer and provider. With no shareholders, our customers are our focus. Our people are all driven by the same purpose – helping people live longer, healthier, happier lives and making a better world. We make health happen by being brave, caring and responsible in everything we do. We encourage all of our people to “Be you at Bupa”, we champion diversity, and we understand the importance of our people representing the communities and customers we serve. That’s why we especially encourage applications from people with diverse backgrounds and experiences. Bupa takes pride in being a Level 2 Disability Confident Employer and will aim to offer an interview/assessment to disabled applicants who best meet the minimum criteria for the role. We’re committed to ensuring you’re treated fairly during the recruitment process and offer reasonable adjustments to anyone who may benefit from accommodations to the recruitment process. If you require information regarding this role in an alternative format, please email: careers@bupa.com Time Type: Full time Job Area: Administration Locations: Egypt - Cairo Be at the heart of helping people live longer healthier, happier lives and making a better world. We employ more than 80,000 people globally who are making this a reality. If you've got the belief, the drive and the talent to help us in our ambition then we’d like to hear from you. Wherever you work, one thing stands out about Bupa people. Our customers are our passion – they’re at the heart of our positively different culture of care. At Bupa you’ll be challenged, you’ll be encouraged to innovate, and collaborate with colleagues who are committed to delivering exceptional experiences. We trust, respect and consider everyone, knowing your difference will make the difference.

Responsibilities

The Provider Contract Executive will support the development and maintenance of Bupa Global's network of providers in Egypt, ensuring high-quality healthcare and cost management. Responsibilities include preparing negotiation plans, managing provider relationships, and monitoring claims spend.