Administration-Jobs in Deutschland

Job Purpose

Support and implement provider contracting strategies to enhance network efficiency, improve cost-effectiveness, and foster strong provider relationships. The role involves managing contract administration, monitoring provider performance, and ensuring adherence to contractual agreements. Assisting in negotiations, analysing cost structures, and supporting regulatory compliance efforts, the role will contribute to financial sustainability and service quality.

Key Responsibilities

Core Responsibilities:

• Manage provider contracts, ensuring timely renewals and adherence to agreed terms.
• Conduct market analysis to assess provider distribution, mix, and financial impact.
• Negotiate contract terms to enhance cost efficiency while maintaining service quality.
• Monitor provider performance using KPIs, cost benchmarks, and quality measures.
• Ensure compliance with contractual obligations, regulatory standards, and internal policies.
• Analyse financial and utilization data to propose cost-containment strategies.
• Develop and present reports on network adequacy, provider performance, and financial trends.
• Liaise with regulatory bodies to ensure alignment with healthcare policies.
• Address escalated provider issues and ensure timely resolution of disputes.
• Oversee communication with providers regarding policy updates and procedural changes.
• Assist in preparing reports and presentations for senior management on contracting activities.

Quality & Excellence Management:

• Ensure adherence to regulatory and contractual requirements for provider contracting.
• Monitor contract compliance and support corrective action plans when necessary.
• Assist in the development and implementation of quality improvement initiatives for provider engagement.
• Contribute to process improvements that enhance efficiency and reduce operational risks.
• Support internal audits and regulatory reporting related to provider network management.

Qualifications and Experience

Preferred Educational Qualifications and Professional Certifications

• Bachelor’s degree in business administration, Medical, Healthcare or a related field.
• Master’s degree in business administration, Medical, Healthcare or a related field.
• Professional certifications such as Certified Professional in Healthcare Management (CPHM), Certified Healthcare Financial Professional (CHFP), Certified Professional in Healthcare Quality (CPHQ) or equivalent are a plus.

Experience

• Minimum 5-7 years of experience in provider contracting, healthcare insurance, or network management with at least 2-3 years in a supervisory role.