مدير حوكمة العقود

Job Purpose

responsible for establishing, implementing, and overseeing governance frameworks for payer contracts to ensure compliance, consistency, and financial optimization. The role ensures that all contracts are aligned with CCHI regulations, NPHIES requirements, and internal policies, while safeguarding revenue integrity, minimizing risk, and enhancing transparency across the organization.

Organizational Accountabilities

• Establishing and maintaining contract governance frameworks across all payer agreements
• Ensuring compliance with CCHI regulations, NPHIES standards, and internal policies
• Enhancing revenue integrity by ensuring proper implementation and monitoring of contract terms
• Minimizing financial, legal, and operational risks associated with payer contracts
• Ensuring standardization and consistency of contract management practices across the organization
• Supporting audit readiness and regulatory compliance
Promoting transparency, accountability, and control in contracting processes

Functional Accountabilities

Develop and implement contract governance policies, procedures, and standards

Establish contract lifecycle management processes (creation, approval, renewal, termination)

Define roles, responsibilities, and approval matrices for contract management

Ensure all contracts comply with CCHI regulations, payer requirements, and healthcare laws

Align contracts with NPHIES workflows and digital health requirements

Monitor regulatory changes and ensure contract updates accordingly

Oversee contract implementation and ensure accurate system configuration in HIS and billing systems

Ensure proper interpretation and application of contract terms across RCM functions

Monitor adherence to contract terms and identify deviations

Identify risks related to contract gaps, pricing errors, or misinterpretation

Implement controls to prevent revenue leakage and ensure correct reimbursement

Conduct regular contract audits and compliance reviews

Develop dashboards and KPIs to monitor contract performance and compliance

Analyze reimbursement trends, variances, and payer performance

Provide insights and recommendations to senior management

Act as the primary governance liaison between RCM, Finance, Legal, and Commercial teams

Coordinate with payer contracting teams and external stakeholders

Provide guidance and training to internal teams on contract governance

Ensure proper maintenance of centralized contract repository

Implement version control, audit trails, and documentation standards

Ensure accessibility and security of contract records

Identify opportunities to automate contract management and governance processes

Support implementation of contract management systems

Enhance efficiency and control through digital tools and analytics

Key Internal Stakeholders

• Revenue Cycle Management (Billing, Coding, Claims, and Collections).
• Finance and Accounting.
• Medical and Clinical Departments.
• Commercial / Business Development.
• IT and Systems Teams.

Key External Stakeholders

• Insurance companies and TPAs.
• Council of Cooperative Health Insurance (CCHI).
• NPHIES platform stakeholders.
• External auditors and consultants.

Knowledge and Experience

8–11 years of experience in healthcare contracting, RCM, or financial governance

Minimum 3–5 years in a governance, managerial, or leadership role

Strong experience in payer contracts and contract lifecycle management

In-depth knowledge of CCHI regulations and Saudi insurance frameworks

Strong understanding of NPHIES workflows and claims ecosystem

Experience in financial controls, audit, and compliance frameworks

Familiarity with contract management systems and ERP/HIS platforms

Education and Certifications

Bachelor’s degree in Healthcare Administration, Law, Finance, Business Administration, or related field . (required)

Master’s degree MBA or Healthcare Management. (preferred)

CPA / CMA / SOCPA (Preferred)

Contract Management Certification (e.g., CCCM, CPCM) (Preferred)

Healthcare Revenue Cycle certification (Preferred)

Training in CCHI and NPHIES(Preferred)

Risk management or governance certifications (Preferred)

Skills

Strong negotiation and communication skills

Analytical and financial assessment skills

Attention to detail and contract accuracy

Understanding of healthcare revenue cycle processes

Ability to interpret legal and contractual language

Problem-solving and decision-making skills

Stakeholder management and coordination

Proficiency in Microsoft Excel and reporting tools

Knowledge of healthcare systems (HIS, billing systems)

Attitude:

Strong Work Ethic

Dependability and Responsibility

Possessing a Positive Attitude

Adaptability

Honesty and Integrity

Self-Motivated

Motivated to Grow and Learn

Strong Self-Confidence

Competency:

Accountability

Communication

Collaboration

Integrity & Confidentiality

Contract Management

Payer & Insurance Knowledge

NPHIES Knowledge

Revenue Cycle Understanding

Financial & Pricing Analysis

Regulatory Compliance

Analytical Thinking

Problem Solving

Negotiation Skills

Time Management

Adaptability