To support the Head of Health and Benefits BGME in developing, improving and maintaining Bupa Global’s network of providers in Middle East and North Africa.
To support research into the relevant approach for the market: direct contracting, hospital network access, cost management through TPA’s or other third party arrangement, and to support delivery of the recommended approach, through to contract compliance
To manage a portfolio of providers and TPAs / geographical areas delivering strong network position and cost management through direct contracting or relationships with external partners and correspondents
To liaise with internal stakeholders in a range of departments to ensure that interested parties are consulted and operational capability to support the recommended approach is in place
Implement, develop and maintain Global’s Health and Benefits strategy for the region, ensuring alignment with Bupa Global’s product and proposition development, and sales and service agendas.
Achieve personal targets and develop pipeline for future activity.
Research availability and quality of healthcare provision in allocated markets and recommend appropriate purchasing and claims spend management approaches, being direct contracting, network access agreement, cost management arrangements through third parties or product structure and policy application rules. Negotiate and oversee negotiations of contracts with providers and / or target partners to enable access to healthcare, delivering financial and commercial advantage through best price and quality care for our customers. Build appropriate networks of providers offering comprehensive ranges of inpatient and outpatient services on a cashless basis. Act as Healthcare Services lead to ensure successful implementation of operational structures to support delivery of negotiated third party cost management and network access arrangements.
In accordance with BG agreed protocols manage provider in Egypt ensuring delivery of high quality, cost effective customer-focused healthcare to all Bupa International members consistent with Bupa brand and values. Act as point of referral for escalated queries. 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 H&B review and regularly monitor Bupa Global’s claim spend in allocated markets 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 allocated markets, support the definition and execution of strategies to extend provider coverage e.g. to build doctors’ networks with agreed discounts and direct settlement, or other outpatient direct settlement arrangements. Support the development of speciality networks as required.
Interface with other teams in H&B 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 Global to improve the level of service to our customers.
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).
The Ideal Candidate
Previous experience, preferably in international private medical insurance or negotiation.
Perfect command of English and Arabic, both written and verbal.
Strong commercial knowledge of the international health insurance industry; particular knowledge of healthcare systems within the Egypt and MENA would be an advantage
Strong insight knowledge of regional hospital industry and its pricing and quality dynamics.
Excellent commercial negotiation skills, able to deal with high level hospital administrators but also at operational management level.
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.
UAE Nationals preferred
About The Company
Bupa’s purpose is longer, healthier, happier lives.
As a leading global health and care company, we offer health insurance, medical subscription and other health and care funding products; we run care homes, retirement and care villages, primary care, diagnostic and wellness centres, hospitals and dental clinics. We also provide workplace health services, home healthcare, health assessments and long-term condition management services. We have 32M customers
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