The Akessa Healthcare Group is seeking a Group Contract and Medical Insurance Pricing Analyst to manage its pricing and contractual relationships with medical insurance companies.

The insurance contract management function is at the forefront of the hospital business and works to develop good working relationships with private medical insurance companies. The post holder will be responsible for managing the hospitals’ existing commercial contract arrangements as well as exploring alternatives.

The appointee will join a well-led, strong finance team and will report to the Director of Finance. The seniority of the role reflects the hospital’s requirement for an independent self-starter with a solid understanding of the private medical insurance and pricing analysis who is able to work with minimal supervision. A professional and proactive approach, supported by excellent communication and interpersonal skills, are a pre-requisite and key to the success of the role. Prior experience operating at senior management level is essential.

Relevant contract experience in the healthcare industry, in particular medical insurance companies, is essential and a postgraduate qualification is desirable. While stated as a full time role, a part time more flexible arrangement may be considered. This is a challenging role and a great opportunity for a dynamic and self-motivated individual.

About Us:

The Akessa Healthcare Group owns and operates several boutique independent hospitals including The New Foscote Hospital, Royal Buckinghamshire Hospital and 107 Harley Street.

The New Foscote Hospital was established in Banbury over 40 years ago and has provided services and treatments to thousands of people from across the region. We have over 70 consultants, all of whom are leaders in their specialist fields and choose to hold their private practices here, working alongside our friendly, highly qualified, and experienced nursing and support teams.

The Royal Buckinghamshire Hospital was established in Aylesbury in 1832 and has provided services and treatments to thousands of people from across the region. The ownership of the hospital was transferred to our new management team in January 2023. By joining our existing portfolio, the hospital is now run professionally and provides clinical care to private, insured and NHS patients, with a strong ethos on caring for our staff.

107 Harley Street, is an outpatient, diagnostic and day-case facility. The Group has had a presence in the Harley Street area since 2010. The treatments offered at this facility includes oral and maxillofacial surgery, dermatology, orthodontics and specialist dentistry, plastic and cosmetic surgery, general surgery and rheumatology.

The clinical outcomes of the hospital are of the highest standards and the latest CQC report rated our hospital standards as good across all parameters. Our organisation has strong IT, operational, clinical governance and accountancy support. All colleagues are encouraged to feel empowered and to have an active voice on the management of their services.

Responsibilities include the following:

• Analyse and manage self pay pricing to maintain profitability of procedures and ensure correct placement within the market.
• Develop, negotiate and maintain contracts with all medical insurance companies. This includes researching territories to identify gaps with our payer base and supporting the expansion into new markets.
• Assure contractual arrangements meet financial targets and legal/regulatory compliance requirements. There will be an emphasis on analysing cost and utilisation data.
• Facilitate the approval process of all contract documents from pre-contract through post signature phases.
• Responsibility for the accurate completion of documents and supporting documentation for contracts.
• Responsibility for maintaining the accuracy of the contracts model within the EPR software (Compucare8)
• Develop and maintain processes that provide timely notification of critical contract events (e.g., renewals, termination and due dates contained within the agreements).
• Maintain existing relationships with contracted providers and ensure contracts are kept current while evaluating the fee schedule on a yearly basis to identify possible opportunities for additional covered services, medical policy changes and reimbursement.
• Coordinate and communicate contractual terms to the billing department and ensure staff are informed of changes in medical policy and billing policies.
• Conduct on-going assessments of assigned networks and make recommendations for strategic initiatives, goals and objectives.
• Develop and maintain periodic, e.g., bi-weekly, reports on the status of all contracts.
• Assure accurate data entry of contract specifications and terms into database and completeness of all contracting processes.
• Assist with all contracting administration and projects, as needed.
• Identify and promote change within existing contracts.
• Maximise and extract value from both its existing commercial relationships as well as any new projects including any re-procurements.
• Liaise with the medical insurance companies to enable effective provision of services and to ensure they are seen as a key provider for commissioned services.
• Actively seek out new procurement and contract opportunities, ensuring these are effectively pursued either through in-house bids or working with external bid writing partners.
• Act as a point of contact, and lead on the management of contracts, ensuring that all issues are effectively addressed and managed.
• Work in close partnership with other departmental managers.
• Work with operational teams to ensure that patient choice is effectively championed and provided.
• Maintain excellent written and verbal communication with all internal and external customers.
• Actively participate in establishing strategic business goals with the Leadership Team.

Qualifications and Experience:

• Experience within health system insurance contracting desirable
• Qualified accountant (ACA, ACCA, CIMA or equivalent)
• Bachelor’s Degree or equivalent experience.
• Able to demonstrate strong knowledge and understanding of the healthcare industry along with legal and regulatory requirements.
• Willingness to actively participate in all aspects of the contract administrative process. This is a hands-on working role.
• Proven exceptional partnership, interpersonal and contract negotiation skills.
• Ability to develop and deliver presentations to internal and external groups.
• Results driven and able to work independently whilst showing initiative but will also seek guidance when appropriate.
• Ability to multi-task, have excellent attention to detail and be flexible in a fast paced and growing organisation.
• Strong knowledge in computer software, e.g., MS Office Suite, PowerPoint, social media and internet-based research.
• Experience of working at a medical insurance company, (BUPA, AXA, AVIVA, WPA, Vitality) highly preferred.
• Knowledge and use of Compucare software preferred but not required.

Job Types: Full-time, Permanent

Pay: From £50,000.00 per year

Benefits:

• Company pension
• Employee discount
• On-site parking
• Private medical insurance

Schedule:

• Day shift
• Monday to Friday

Experience:

• health system insurance contracting: 1 year (preferred)

Licence/Certification:

• ACA, ACCA, CIMA or equivalent (required)

Work authorisation:

• United Kingdom (preferred)

Work Location: In person