Manager - Medical Contract Compliance & Performance (Del-285)

Overview

2.1 Staffing & Deployment Verification

• Maintain a real-time staffing tracker that maps actual deployed personnel against the contracted complement for every shift, role, and venue, identifying shortfalls, unauthorized substitutions, or uncovered positions as they occur
• Verify provider-submitted timesheets against deployment records before any submission reaches procurement; reject or flag timesheets that do not match verified attendance and actual hours worked
• Formally document all staffing deviations, including their duration, affected roles, and operational impact, creating an auditable compliance record that supports escalation and financial deduction calculations
• Verify that all deployed personnel hold valid professional licences, SCFHS registration, and role-specific certifications as required under the contract, flagging any lapse immediately

2.2 Invoice Review & Financial Verification

• Review all provider invoices in detail before submission to procurement, cross-checking billed amounts against contracted rates, verified deployment hours, approved variations, and applicable deductions
• Calculate and apply financial deductions for staffing shortfalls, SLA breaches, non-compliance penalties, and any other contractually defined conditions, ensuring deductions are accurately reflected in the approved invoice before it is forwarded to procurement
• Maintain a financial tracker covering all billing cycles - amounts submitted, amounts approved, amounts disputed, and amounts deducted - providing CMS with a clear and current view of contract expenditure versus contracted value
• Liaise directly with the contracted provider to resolve invoice discrepancies, obtain supporting documentation, and ensure all submissions are accurate and complete before approval

2.3 KPI & Service Performance Monitoring

• Monitor contracted KPIs on an ongoing basis, including clinical response times, staffing coverage hours, equipment readiness, licence validity, and any other indicators defined in the service agreement
• Maintain a live compliance log capturing KPI performance against targets, with supporting evidence, trend analysis, and a running record of breaches and remediation actions
• Conduct periodic contract performance reviews, producing structured scorecards that assess provider performance across all contractual dimensions and identify patterns of non-compliance requiring escalation
• Develop and maintain a contract risk register, documenting active compliance risks, their likelihood, operational impact, and the status of mitigating actions

2.4 Provider Liaison & Compliance Management

• Serve as CMS's primary direct contact with the contracted healthcare provider on all matters relating to staffing compliance, invoice verification, performance monitoring, and documentation requests
• Issue formal compliance notices, requests for corrective action, and supporting correspondence to the provider, maintaining a complete and auditable record of all formal communications
• Track corrective action commitments made by the provider, follow up on implementation timelines, and verify that corrective actions have been effectively completed before closing findings
• Coordinate with procurement on contract submissions, approved variations, and any matters requiring formal contract management action, ensuring CMS's position is clearly documented and supported by evidence

2.5 Regulatory & Licensing Compliance

• Monitor the contracted provider's regulatory standing, including Ministry of Health facility licence validity, SCFHS registration status of all deployed staff, and compliance with any other applicable regulatory requirements
• Maintain a licence and certification expiry tracker for all contracted staff and facility approvals, alerting the provider and escalating to CMS leadership when renewals are at risk of lapsing
• Ensure CMS's own contract management practices comply with Qiddiya Investment Company procurement policies, internal audit requirements, and applicable Saudi regulations

2.6 Reporting & Performance Dashboards

• Prepare and present monthly contract performance reports to the Senior Manager, CMS, covering staffing compliance, KPI status, invoice verification outcomes, financial deductions applied, and open corrective actions
• Develop and maintain Power BI or equivalent dashboards that give CMS leadership a real-time view of contract compliance status, financial position, and provider performance trends
• Contribute contract performance data and financial analysis to CMS executive reporting cycles and any QIC-level governance or audit processes as required

Requirements

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, Law, or a related discipline
• Professional certification in Contract Management (CPCM), Healthcare Compliance (CHC), or Internal Audit (CIA) is strongly preferred

3.2 Experience

• Minimum 5-8 years of experience in healthcare contracting, provider relations, compliance monitoring, or a closely related function
• Demonstrated experience reviewing invoices and financial claims against contractual terms, with a track record of identifying discrepancies and applying appropriate financial adjustments
• Experience monitoring healthcare service contracts, tracking KPIs and SLAs, and producing structured compliance reports for senior leadership
• Familiarity with Saudi healthcare regulations, including Ministry of Health licensing requirements and SCFHS registration frameworks as they apply to contracted service providers

3.3 Skills & Competencies

• Strong analytical and financial verification skills, with high proficiency in Excel; experience with Power BI or equivalent reporting tools is an advantage
• Sound understanding of healthcare KPIs, SLAs, and performance measurement frameworks applicable to contracted clinical services
• Excellent written communication skills; able to produce clear, evidence-based compliance reports, formal notices, and executive summaries
• High integrity and attention to detail; able to maintain objectivity and professional conduct when managing compliance findings and financial disputes with the contracted provider
• Effective stakeholder management skills; comfortable engaging directly with the contracted provider while maintaining a clear boundary between liaison and enforcement authority