Healthcare Network Procurement & Data Manager

GIG Gulf; Dubai; On-site; AED 240,000 - 420,000; Full time

Job summary

GIG Gulf, part of the Gulf Insurance Group, seeks an experienced professional to manage its Provider Network across GCC markets. You will lead negotiations, network development, governance, and regulatory compliance to drive profitability and growth.

The role requires deep knowledge of GCC healthcare insurance regulations and extensive relations with healthcare providers across the region. You will coordinate with compliance and legal to ensure regulatory alignment and cost-effective network

Qualifications

• Extensive knowledge of Healthcare Insurance in GCC countries.
• Expert knowledge of the different Legislations and Regulations in GCC countries.
• Extensive connection with Healthcare providers in GCC countries.

Responsibilities

• Manages the GIG Gulf Provider Network and development through the implementation of the agreed providers’ management strategy.
• Leads annual cycles of provider negotiations, contracting activity and cost containment initiatives.
• Manages network administration, contract databases and discount/ rebate implementations.
• Delivers governance, reporting and regulatory compliance for provider networks.
• Leads end-to-end provider empanelment and market analyses to support business objectives.

Skills

Healthcare knowledge

Regulatory knowledge

Stakeholder management

Job description

GIG Gulf is part of the Gulf Insurance Group (GIG), the #1 largest regional composite insurer in the Middle East and North Africa, with presence in 13 markets including the United Arab Emirates, Bahrain, Oman, Qatar, Saudi Arabia, Algeria, Egypt, Iraq, Jordan, Kuwait, Lebanon, and Turkey. GIG Group reported consolidated assets of US$ 3.83 billion and $69 million net profit for the year 2023. The majority shareholder of GIG Group is Toronto based Fairfax Financia Holding, a global leader in insurance and reinsurance with a presence in 40 markets.

GIG Gulf is an ‘A’ rated regional insurer with a top 5 position in each of its markets (UAE, Oman, Qatar, Bahrain). GIG Gulf has been present in the region for over 70 years with a strategic focus on both growth and investments and is a one stop shop offering a wide range of insurance products and services that cater to a broad variety of needs for corporates, SMEs and individual customers throughout UAE, Oman, Bahrain, and Qatar. GIG Gulf also owns a 50% stake in GIG Saudi. Our strategic objectives and guiding principles are focused on Regional Growth, Customer Experience and Digital Transformation.

GIG Gulf has created a diverse and inclusive working environment and culture with a workforce of over 800 employees, with over 60 nationalities, across 15 branches and retail shops region-wide and over 1 million customers. GIG Gulf is a caring partner that encourages customers to achieve their goals and live an inspiring and fulfilling life. We are obsessed with customer feedback and continuously evolving to become the region’s digital insurer of reference, committed to running our operations in a responsible, sustainable way.

Job purpose:

To manage the GIG Gulf Provider Network and development through the implementation of the agreed providers’ management strategy while complying with official regulation to achieve quality, accessible and affordable healthcare that support business to achieve business profitability and expansion goals.

Key Responsibilities:

• Manages allocated direct reports to deliver business goals.
• Recruits, develops, trains, evaluates, and coaches staff/self to provide cost effective Network Management and administration while ensuring quality and efficiency standards are met.
• Manages workload and resource allocations to monitor work output to ensure staffing levels are correct and team performance remains high.

Network Management

• Leads annual cycle of Provider Negotiations – Proactive and Reactive – to deliver agreed business goals through effective negotiations and contracting activity.
• Manages network administration and contract database processes and outputs.
• Manages the implementation of discounts/ rebates and agreed contractual terms. Timely collect volume rebate, upfront, early payment discount, with medical providers and network partners.
• Lead implementation of network related cost containment initiatives to ensure they are delivered effectively, efficiently and profitably.
• Conduct regular studies of providers’ allocation based on risk cost.
• Identifies potential areas for price reductions to achieve business targets with the assigned providers.

Network Development

• Identifies areas for potential network development to achieve business objectives based on stakeholder requirements and sales team input/feedback.
• Leads market analyses and research of competitor networks to enable business stakeholders’ competitiveness.
• Manages the end-to-end provider empanelment process.
• Monitor the operation of comprehensive network of providers that covers all benefits for each class and identifies new contracting opportunities.

Network Data Management

• Delivers, maintains, and enhances benchmarking for provider prices, competitor networks with regular internal and market analyses
• Designs and implements provider quality control measures such as provider details accuracy, provider profile audits, data quality assurance, system tariff audits
• Leads negotiations driven by in depth review of provider service and pricelist utilizations, identifying top utilized services, billing trend analysis
• Calculates and analyzes the financial impacts of proposal and agreements of new contracts/service codes and renewals.

Governance and reporting

• Delivers reporting to meet business needs: provider negotiations, contracting activity, recoveries, rebates, activity
• Liaising with compliance and legal to ensure the fulfillment of regulatory requirements.
• Working on regulatory requirements.

Project Management

• Represents the Healthcare network management on functional projects to develop cost containment strategies.
• Identifies opportunities for changes in healthcare delivery for Providers.
• Leads and represents Healthcare Network function on design and implementation of regulatory system requirements and changes in GCC region
• Leads communications with providers and vendors on regulatory changes and compliance requirements.
• Identifies and leads negotiations with providers on cost saving opportunities resulting from implementation of regulatory coding and billing mandates

Role Requirements:

• Extensive knowledge of Healthcare Insurance in GCC countries.
• Expert knowledge of the different Legislations and Regulations in GCC countries.
• Extensive connection with Healthcare providers in GCC countries.