Healthcare Insurance Network Manager
4 days ago
Key Responsibilities
The Senior Insurance Manager will be responsible for:
1. Leading contract negotiations with major local and international payers and third-party administrators.
2. Managing ongoing payer operations and relations, including denial management, process improvement and pricing.
3. Developing business plans, financial models, market studies, and presentations on hospital sustainability plans, managed care operations and market share growth.
4. Guiding the development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management.
5. Evaluating and negotiating contracts in compliance with company templates, reimbursement structure standards and other key process controls.
6. Ensuring network composition includes an appropriate distribution of provider specialties.
7. Providing explanations and information to others on difficult issues.
8. Acting as a liaison between parties during contract development and negotiations, ensuring terms and conditions are agreeable to all parties.
9. Sharing contract processes, conditions, and details with hospital management, business partners, and relevant employees.
10. Clarifying contract-related information and answering questions from stakeholders.
11. Drafting, revising, and incorporating changes into contracts as required during negotiations.
12. Reviewing contracts, verifying accuracy, and resolving discrepancies in line with company rules and guidelines.
13. Collaborating with teams on enterprise-wide revenue cycle improvement, contracting and pricing initiatives within Qatar.
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Senior Insurance Manager
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