Manager Health Economics & Provider Analytics📣 Job Ad

About the Role

Bupa Arabia is seeking a Manager - Health Economics & Provider Analytics to join its team in Jeddah. This full-time role focuses on executing specific deliverables and activities to analyze and validate statistical data. The position utilizes advanced analysis to identify and quantify impacts on medical cost trends, with the objective of providing the highest appropriate quality and cost-effective care for Bupa Arabia members.

Core Responsibilities

The Manager - Health Economics & Provider Analytics will oversee critical functions related to healthcare data analysis, business optimization, provider relations, and advanced analytics. Key responsibilities include:

Healthcare Data Analysis and Management

• Design data models that integrate patient data from multiple sources to create comprehensive views of health data.
• Perform health risk segmentation for members and profile chronic cases (*, chronic disease, cancer, hepatic disease, renal failure) to support cost savings and customer retention.
• Conduct feasibility and impact studies for planned projects.
• Publish monthly reports for top providers, detailing high-value drivers, medications, and cases.
• Apply advanced categorization of services with standardized and concise mapping.
• Manage the initiation and maintenance of new enhancement segmentation for services and medical conditions.
• Ensure proper validation of doctor names, specialties, and the unified service coding process within the data.

Business Optimization and Provider Relations

• Develop quantified business waste analyses for outlier behavior or billing irregularities.
• Identify and eliminate inefficiencies to create a portfolio of work leading to savings.
• Share savings opportunities from recoveries or prevention and monitor provider inflation according to medical conditions and benefits.
• Validate savings before and after executed actions by measuring the realized impact of cost management activities.
• Develop and review commercial terms with providers within Bupa’s network, as well as prospective providers for network inclusion.
• Create and implement new templates for price comparison and impact studies, considering variations in providers’ billing and service complexity.

Analytics Transformation and Inflation Monitoring

• Collaborate with different business units and functions to execute assigned objectives related to Big Data projects and digital enhancements, transformations, and implementations.
• Interpret and validate data for incorporation into advanced analytics and Machine Learning models.
• Monitor medical inflation figures with ongoing effective oversight of all potential impacts that may affect costs in both short-term and long-term perspectives.
• Provide information about various cost trends, initiatives being taken in operations, and monitor progress against each initiative and exceptions that require action.

Required Experience

Candidates for this full-time position should possess 2-5 years of relevant professional experience. The role requires a strong analytical background and the ability to apply advanced data analysis techniques within a healthcare context.