Contracting Senior Specialist

Job Purpose

Organizational Accountabilities

• Mentor and support the contracting team by guiding subordinates in handling day-to-day activities and operational tasks when required.
• Ensure compliance with Commercial Affairs standards, protocols, policies, and regulations.
• Ensure accurate interpretation and implementation of contractual terms and conditions.
• Minimize financial risks and revenue leakage through effective management of contractual matters.
• Perform data analysis and reporting activities when required.
• Maintain and organize all contractual records, whether physical or electronic.
• Perform any additional job-related duties assigned by the direct manager based on business requirements.

Functional Accountabilities

• Study and assess financial impacts related to contracts and pricing when necessary.
• Conduct periodic reviews of all credit price lists.
• Conduct periodic reviews of all active contracts.
• Negotiate with insurance companies and TPAs regarding the addition of new services, medical devices, milk products, hearing aids, imported medications, and other related items.
• Support insurance-related and TPA-related initiatives and special agreements such as per diem arrangements.
• Identify opportunities to improve contractual terms, conditions, and pricing structures.
• Provide clarification and support regarding contractual terms and conditions.
• Draft direct agreements and memorandums with non-insurance organizations.
• Coordinate with relevant internal stakeholders on all contractual matters and related activities.

Key Internal Stakeholders

• All staff members.

Key External Stakeholders

• Insurance companies.
• Third-Party Administrators (TPAs).
• Non-insurance organizations.

Job Qualifications and Requirements

• Knowledge and Experience
• Relevant knowledge in the healthcare and/or health insurance sector with a minimum of 3–5 years of related experience.

Education

• and Certifications
• Bachelor’s Degree in Business Administration, Finance, Accounting, Economics, Insurance, or a related field (Required).
• RCMS (Revenue Cycle Management Specialist) certification or equivalent (Preferred).
• Data Analysis certification or equivalent (Preferred).
• PMP certification (Preferred).

Skills

• Strong interpersonal skills including communication, problem-solving, creative thinking, and leadership.
• Negotiation skills.
• Strong linguistic and communication abilities.
• Proficiency in Microsoft Office applications.
• Risk management skills.
• Legal and regulatory knowledge.
• Data and financial analysis skills.
• Project management skills.
• Attention to detail.
• Stakeholder coordination and management skills.

Attitude

• Positive attitude.
• Strong work ethics.
• Honesty and integrity.
• Self-motivation.
• Learning and growth mindset.
• Confidence.
• Confidentiality.
• Dependability and responsibility.
• Adaptability.

Competencies

• Time Management.
• Prioritization.
• Communication.
• Collaboration.
• Market Knowledge.
• Analytical Thinking.
• Compliance.