Manager Health Economics & Provider Analytics📣 Job Ad

About the Role at Bupa Arabia

Bupa Arabia is seeking a Manager Health Economics & Provider Analytics to join its team in Jeddah and Makkah, Saudi Arabia. This full-time position is central to analyzing and validating statistical data through advanced methods. The role's core purpose is to identify and quantify impacts on medical cost trends, ultimately contributing to the provision of high-quality, cost-effective care for Bupa Arabia's members.

Key Responsibilities

The Manager Health Economics & Provider Analytics will execute specific deliverables and activities across several critical areas, focusing on data-driven insights and strategic provider management. Key responsibilities include:

• Designing and implementing data models for comprehensive health data views.
• Conducting detailed analysis of medical cost trends and identifying opportunities for efficiency.
• Developing and reviewing commercial terms with healthcare providers.
• Monitoring provider inflation and ensuring cost-effective care delivery.
• Collaborating with internal business units on digital and data transformation projects.

Healthcare Data Analysis and Insights

• Design data models that integrate patient data from multiple sources to create complete 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, high-value medications, and high-value 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 in the data.
• 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 ML models.

Provider Strategy and Cost Management

• 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 introduction.
• Create and implement new templates for price comparison and its impact studies, considering all variations in providers’ billing and service complexity.
• Monitor medical inflation figures with ongoing effective oversight of all potential impacts that may affect cost on 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 actions.

Required Experience

Candidates for the Manager Health Economics & Provider Analytics role should possess 5 to 10 years of relevant experience in health economics, provider analytics, or a related field. This full-time position requires a professional with a strong background in data analysis and strategic healthcare management.

Joining Our Team

This role offers a significant opportunity to contribute to Bupa Arabia's commitment to delivering high-quality, cost-effective healthcare solutions to its members in Jeddah and Makkah. We encourage qualified professionals to apply.