Job Description

Accountabilities & Activities:

Commercial support

• Partner with the Hospital Contract Manager in preparing for high value provider contract renewals, providing analytical / commercial insights and support to develop contract renewal plans and to develop ‘out of contract’ contingency plans.

• Lead on the design and evaluation of new / change in provider tariff structures. Such agreements may include value based contracting, growth discounts, bundled payments and risk sharing.

• Play an active role in the negotiation of high value contracts with providers, working alongside the Hospital Contract Manager, providing commercial and analytical support during negotiation meetings.

• Responsible for appropriateness and accuracy of anything analytics related in provider contracts.

• Evaluate the success of strategies and tactics executed, provide insights and refine and adapt as needed.

• Regularly monitor the impact of H&BM initiatives on Bupa spend with providers, providing insight to Hospital Contract Managers and providers on reasons for change.

• Monitor hospital business activities, trends across the market place, investments and market share, considering opportunities for Bupa’s relationships with providers.

• Maintain awareness of managed care trends, competitive managed care activities and market developments and recommend, implement and administer related responses

• Contribute as a key member of the Leadership Team and other committees addressing the strategic goals of the department and help shape the strategic approach for Bupa purchasing services in the provider market.

Oversight and control

• Partner with the Head of Hospital Management to monitor provider contract status and renewal plan status, ensuring that contract renewal planning is undertaken in line with delegated authorities and internal governance processes.

• Facilitate the internal approval of changes to high value provider contracts, in line with the delegated authorities, by providing approving Directors with independent assessment of commercial impact and risks.

• Provide independent scrutiny over exceptional payments to providers (e.g. retrospective growth rebates or contractual disputes) in line with delegated authorities, ensuring that final agreed values are appropriate.

• Provide oversight of provisions held in financial accounts for exceptional payments to providers, ensuring that provisions are made where necessary and that balances are accurate and evidenced by supporting schedules / audit trail.

• Working with colleagues in the Analytics team, identify non-compliant / suspicious provider billing or treatment practices and recommend actions to be taken as part of provider management strategy

Management reporting

• Systematically review high value provider contracts (<£10m pa) analysing provider’s own financial performance, their relative affordability, market share and cost growth trends, sharing insights with the Hospital Contract Managers.

• Coordinate reporting and forecasting of hospital price increases and impact of changes in tariff structure, working with Hospital Management team to ensure impact of contracts are accurately reported / forecast.

• Perform complex financial analyses to identify medical cost trends and improvement opportunities, working with the provider management teams then develop / propose strategies to resolve.

• Support benefits reporting to corporate customers by gathering, integrating and distributing data and communications on provider management initiatives.

What’s a typical day?

You will be leading on the design and evaluation of new / change in provider tariff structures. Such agreements may include value-based contracting, growth discounts, bundled payments and risk sharing.

You would play an active role in the negotiation of high value contracts with providers, working alongside the Hospital Contract Manager, providing commercial and analytical support during negotiation meetings. In addition to this you will be responsible for appropriateness and accuracy of anything analytics related in provider contracts.

You would evaluate the success of strategies and tactics executed, provide insights and refine and adapt as needed. Maintaining awareness of managed care trends, competitive managed care activities and market developments and recommend, implement and administer related responses will be part of the role as well.

Who we’re looking for: Qualifications, Training & Experience:

• Strong team player focussed on delivering own objectives while enabling / supporting others to deliver theirs.
• Highly analytical and commercial, confident working with large data sets to identify trends, issues and opportunities and to model impact of solutions on customers and the business
• Excellent MS Excel modelling and PowerPoint presentation skills
• Ideally an MBA degree or a qualified accountant with extensive experience of business partnering and commercial support
• Significant experience of managing and negotiating contracts with third party providers / customers
• Systematic approach to managing own workload and prioritising competing demands from multiple stakeholders
• Forward looking, able to identify risks, issues and opportunities early, plus able to identify and drive successful delivery of performance improvements in a challenging environment.

• Highly analytical and commercial, confident working with large data sets to identify trends, issues and opportunities and to model impact of solutions on customers and the business.

• Excellent MS Excel modelling and PowerPoint presentation skills

• Strong influencing skills

• Ideally an MBA degree or a qualified accountant with extensive experience of business partnering and commercial support.

• 5yrs experience of managing and negotiating contracts with third party providers / customers.

• Strong oral and written communication skills, explaining complex issues clearly and concisely, presenting compelling arguments / proposals using fact based evidence and research, adapting style for maximum impact with audiences.

• Systematic approach to managing own workload and prioritising competing demands from multiple stakeholders.

• Forward looking, able to identify risks, issues and opportunities early, plus able to identify and drive successful delivery of performance improvements in a challenging environment.

• Strong team player, focussed on delivering own objectives while enabling / supporting others to deliver theirs.

• Able to challenge constructively and resolve conflict / issues productively.

• Experience of healthcare desirable or other complex, multi service line environment essential.

Required Knowledge, Skills, and Abilities

: Qualifications, Training & Experience: • Strong team player focussed on delivering own objectives while enabling / supporting others to deliver theirs. • Highly analytical and commercial, confident working with large data sets to identify trends, issues and opportunities and to model impact of solutions on customers and the business • Excellent MS Excel modelling and PowerPoint presentation skills • Ideally an MBA degree or a qualified accountant with extensive experience of business partnering and commercial support • Significant experience of managing and negotiating contracts with third party providers / customers • Systematic approach to managing own workload and prioritising competing demands from multiple stakeholders • Forward looking, able to identify risks, issues and opportunities early, plus able to identify and drive successful delivery of performance improvements in a challenging environment. • Highly analytical and commercial, confident working with large data sets to identify trends, issues and opportunities and to model impact of solutions on customers and the business. • Excellent MS Excel modelling and PowerPoint presentation skills • Strong influencing skills • Ideally an MBA degree or a qualified accountant with extensive experience of business partnering and commercial support. • 5yrs experience of managing and negotiating contracts with third party providers / customers. • Strong oral and written communication skills, explaining complex issues clearly and concisely, presenting compelling arguments / proposals using fact based evidence and research, adapting style for maximum impact with audiences. • Systematic approach to managing own workload and prioritising competing demands from multiple stakeholders. • Forward looking, able to identify risks, issues and opportunities early, plus able to identify and drive successful delivery of performance improvements in a challenging environment. • Strong team player, focussed on delivering own objectives while enabling / supporting others to deliver theirs. • Able to challenge constructively and resolve conflict / issues productively. • Experience of healthcare desirable or other complex, multi service line environment essential.