Medical Insurance Contract Manager

Zikry-Pharmacies - Heliopolis, Cairo

81
Applicants for
3 open positions
57
Seen
1
Shortlisted
20
Rejected
Experience Needed:
2 to 3 years
Career Level:
Manager
Job Type:
Full Time
Salary:
Confidential, Bonuses
Languages:
Arabic, English
Vacancies:
3 open positions
About the Job
  • Develop, negotiate and maintain contracts with all payers, e.g., insurance companies, MSOs, IPAs, TPAs and government programs. This includes researching territories to identify gaps with our payer base and supporting the expansion into new markets.
  • Actively participate in establishing strategic business goals with the Leadership Team.
  • Assure contractual arrangements meet financial targets and legal/regulatory compliance requirements. There will be an emphasis on analyzing cost and utilization data.
  • Facilitate the approval process of all contract documents from pre-contract through post signature phases.
  • Responsible for the accuracy of supporting documentation for contracts and completing documents accurately.
  • Develop and maintain processes that provide timely notification of critical contract events (e.g., renewals, termination and due dates contained within the agreements).
  • Maintain existing relationships with contracted providers. Ensure contractual language is kept current; evaluate fee schedule on a yearly basis to identify possible opportunities for additional covered services, medical policy changes, and reimbursement.
  • Coordinate and communicate contractual terms to the billing department; ensure staff is informed of changes in medical policy & billing policies.
  • Conduct on-going assessments of assigned networks and make recommendations for strategic initiatives, goals, and objectives.
  • Develop and maintain periodic, e.g., bi-weekly, reports on the status of all contracts.
  • Assure accurate data entry of contract specifications and terms into database and completeness of all contracting processes.
  • Maintain excellent written and verbal communication with all internal and external customers.
  • Effectively and professionally represent SleepQuest to the provider community.
  • Assist with all contracting administration and projects, as needed.
Job Requirements
  • Minimum of 2-3 years of relevant experience with pharmacy and health system contracting
  • Bachelor’s Degree in pharmacy or equivalent experience
  • Strong demonstrated knowledge and understanding of the healthcare industry, legal and regulatory requirements
  • Exceptional and proven provider partnership skills and interpersonal skills
  • Excellent contract negotiation skills
  • Ability to develop and deliver presentations to internal and external groups
  • Results driven, persistent - able to self-direct and work independently showing initiative, while seeking guidance when appropriate.
  • Ability to multi-task, pay close attention to detail and be flexible in a fast-paced and growing organization
  • Experience working at a medical insurance company, MSO, IPA, TPA highly preferred.
About this Company

Zikry Pharmacies was founded in 1948 by Dr. Sabry Zikry. Under the principle that “family comes first”, Dr. Sabry laid down the foundation for what is now more than 10 pharmacies in Greater Cairo. Zikry Pharmacies is one of the leaders in the Egyptian market due to its wide... (More)

See all Careers and Jobs at Zikry-Pharmacies
Pharmaceutical Jobs in Egypt
Hiring?
Signup for an employer account and Post your Jobs!