Contract and Medical Insurance Pricing Analyst
The Akessa Healthcare Group is seeking a Group Contract and Medical Insurance Pricing Analyst to manage its pricing and contractual relationships with medical insurance companies.
The insurance contract management function is at the forefront of the hospital business and works to develop good working relationships with private medical insurance companies. The post holder will be responsible for managing the hospitals’ existing commercial contract arrangements as well as exploring alternatives.
The appointee will join a well-led, strong finance team and will report to the Director of Finance. The seniority of the role reflects the hospital’s requirement for an independent self-starter with a solid understanding of private medical insurance and pricing analysis who is able to work with minimal supervision. A professional and proactive approach, supported by excellent communication and interpersonal skills, are a pre-requisite and key to the success of the role. Prior experience operating at senior management level is essential.
Relevant contract experience in the healthcare industry, in particular medical insurance companies, is essential and a postgraduate qualification is desirable. While stated as a full-time role, a part-time more flexible arrangement may be considered. This is a challenging role and a great opportunity for a dynamic and self-motivated individual.
Responsibilities include the following:
* Analyse and manage self-pay pricing to maintain profitability of procedures and ensure correct placement within the market.
* Develop, negotiate and maintain contracts with all medical insurance companies.
* Assure contractual arrangements meet financial targets and legal/regulatory compliance requirements.
* Facilitate the approval process of all contract documents from pre-contract through post-signature phases.
* Maintain existing relationships with contracted providers and ensure contracts are kept current while evaluating the fee schedule on a yearly basis.
* Coordinate and communicate contractual terms to the billing department and ensure staff are informed of changes in medical policy and billing policies.
* Conduct ongoing assessments of assigned networks and make recommendations for strategic initiatives.
* Develop and maintain periodic reports on the status of all contracts.
* Assure accurate data entry of contract specifications and terms into the database.
* Assist with all contracting administration and projects, as needed.
* Identify and promote change within existing contracts.
* Liaise with the medical insurance companies to enable effective provision of services.
* Actively seek out new procurement and contract opportunities.
* Act as a point of contact, and lead on the management of contracts.
* Work in close partnership with other departmental managers.
* Maintain excellent written and verbal communication with all internal and external customers.
* Actively participate in establishing strategic business goals with the Leadership Team.
Qualifications and Experience:
* Experience within health system insurance contracting desirable.
* Qualified accountant (ACA, ACCA, CIMA or equivalent).
* Bachelor’s Degree or equivalent experience.
* Strong knowledge and understanding of the healthcare industry along with legal and regulatory requirements.
* Proven exceptional partnership, interpersonal and contract negotiation skills.
* Results driven and able to work independently whilst showing initiative.
* Ability to multi-task, have excellent attention to detail and be flexible in a fast-paced and growing organisation.
* Strong knowledge in computer software, e.g., MS Office Suite.
* Experience of working at a medical insurance company highly preferred.
Job Types: Full-time, Permanent
Pay: From £50,000.00 per year
Seniority level
* Mid-Senior level
Employment type
* Full-time
Job function
* Marketing and Sales
* Industries: Hospitals and Health Care
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