مدير علاقات الدفع

Key Responsibilities and Duties: 1. Contract Execution & Housekeeping: - Maintain accurate records of payer contracts, fee schedules, and policy updates, ensuring timely onboarding into systems and workflows. - Support the housekeeping and maintenance of contractual documents and pricing databases to ensure alignment with the latest agreements. - Implement payer contract terms into operational processes in collaboration with RCM, Finance, and IT teams. 2. Operations & Oversight: - Monitor payer-related performance metrics including denial rates, turnaround times, and underpayments, escalating issues to the Director as needed. - Lead the resolution of day-to-day payer issues, authorization delays, and claim disputes in coordination with internal stakeholders. - Track and ensure adherence to payer service-level agreements and escalate breaches or risks for corrective action. - Manages the escalation process, ensuring timely response and resolution of disputes, denials, and authorization delays in coordination with internal stakeholders 3. Data, Benchmarking & Reporting: - Conduct regular price reviews and benchmarking exercises to maintain competitiveness and identify gaps in payer contracts. - Prepare and maintain operational dashboards and performance reports to support decision-making by the Director and senior leadership. - Perform root-cause analysis of denials and underpayments and recommend corrective actions. 4. Business Development Support: - Support the Director in introducing new service lines and shared programs with payers, including preparing proposals, market analyses, and financial models. - Assist in piloting and evaluating new contracting models and innovations, ensuring operational feasibility and payer buy-in. - Coordinate with commercial and clinical teams to operationalize payer-related business initiatives. 5. Collaboration & Compliance: - Act as a point of contact for payer representatives on operational issues, ensuring timely responses and professional relationship management. - Collaborate with cross-functional teams (RCM, Finance, IT, Clinical Ops) to ensure seamless contract execution. - Ensure compliance with contract terms, regulatory standards, and organizational policies. 6. Other duties as assigned within the scope of the job. Skills and Abilities: - Strong understanding of healthcare payers, managed care principles, and regulatory environments. - Proven leadership and negotiation skills in payer relationship management. - Analytical thinking with the ability to extract insights from performance data. - Excellent communication, problem-solving, and stakeholder management capabilities. Experience: 5 years of experience in revenue cycle management or payer operations, with at least 3 years in a leadership role managing payer interactions and strategy. Education: Bachelor’s degree in healthcare administration, Business Administration, Finance, or related field. Language: Excellent command of oral and written English and prefer Arabic. Licenses / Certifications: N/A