Manager - PR Operations

To manage the commercial and contractual relationship with Bupa network providers so as to ensure the compliance to regulations and the delivery of business benefits.

Reconciliation of the accounts:

·    Set the targets aligned with the overal forecast.

·    Analyze, monitor the cost effectiveness of the unit and utilization of services of the providers to control and drop it year after year.

·     Plan for reconciliation meetings, this will include scheduling meetings, coordination with medical manager, preparation of finacial figures and negotation tools 

·     Negotiate the reconciliation with the providers to achieve the set targets

·     Document the reconciliation facts and send feedback to the claims department and regional manager

·    Prepare presentation to the owners of top 20 provider ,at least once/year to highlight the trends and errors

·   Ensure that the reconciliation is conducted on regular basis and in line with the CCHI regulations

Better commercial terms:

·    Set the targets aligned with the overall forecast

·    Improve the commercial trading terms by negotiating and signing up better prices and discounts to guarantee that Bupa will achieve the price reduction targets set on annual basis.

·     Prepare the proposals for better prices and discount structures of the frequent services and package in coordination with the commecial team and medical manager

·     Negotiate and agree with the providers for better prices

·     Intimate the agreements to  the commercial and support team for uploading and implementation

·    Negotiate better deals for the identified high value claims on real time basis before sending the claims

·   Monitor the compliance of the providers with the agreements on their claims presentation

Communications and trends resolutions:

·    Plan, coordinate and carry regular visits to the providers in order to maintain with them professional relationship.

·    Follow up by phone and with written correspondences on issues raised during negotiation with providers.

·    Identify the unfavourable trends in medical practice of the providers

·     Manage the delivery of training session and development programmes to providers’ staff on Bupa new systems, policies and procedures.

·    Keep continous relation with other medical team in the business including the hospital auditing doctors.

·  Attend to members and providers complaints on medical issues

·       3-5 Years 

·       Analytical, negotiation, planning and communication skills

·       Bachelor of business / engineering / administration