Fahed Al Husami, Provider Relations Operation Manager

Fahed Al Husami

Provider Relations Operation Manager

Bupa Arabia

Location
Saudi Arabia - Jeddah
Education
Bachelor's degree, Marketing
Experience
23 years, 0 Months

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Work Experience

Total years of experience :23 years, 0 Months

Provider Relations Operation Manager at Bupa Arabia
  • Saudi Arabia - Khobar
  • My current job since March 2015

Managed professionally the commercial and contractual relation with Bupa Arabia network providers to assure the compliance of regulation and the delivery of business benefit.
Analysed, monitor the cost effectiveness of the unit and utilization of services of the providers to control and drop the it year after year.
Achieved providers better discount / prices reduction.
Assure to settle the provider accounts by 90% within the end of year.
Support networking team and commercial team to plan for forecasting.

Provider Relations Manager at Bupa Arabia
  • Saudi Arabia - Riyadh
  • October 2013 to February 2015

Acceptance of insurance card and payment terms with 180 providers throughout Riyadh Market. (with total cost above 230 million SR)
Developed and implemented provider classification and ranking formula to contain the medical risk.
Renewal of the Contracts & terms and negotiations with 65 providers, helping to control loss ratio
Contracting with 60 new agreement of providers, including four of NGHA hospitals.
Achieved highest result 2.7 M in terms of reconciliation above target.

Provider Relations Officer at Bupa Arabia
  • Saudi Arabia - Riyadh
  • July 2010 to September 2013

 Report to National Provider Relations Manager
 Escalate the critical problems to provider relation director.
 Handled more than 100 providers (with total cost 80 millions SR)
 Contain medical cost through achieving a certain percentage of shortfall excluding prompt payment and volume discounts agreement.
 Use the previous experience to achieve the target and above the target of the medical shortfall.
 Work with providers to improve our member’s experience when receiving treatment at any of Bupa approved providers.
 Negotiate with provider regarding cost, new agreements, renewal of contracts.
 Build effective and efficient partnership relations with our providers and lobby with them to grant a best performance award in Riyadh and central Province.

Provider Relations Administrator at Bupa Arabia
  • Saudi Arabia - Jeddah
  • April 2010 to June 2010

 Provide logistic support across all units within the department and extends its support to other related departments.
 Analyse provider issues and coordinate with providers to arrive at amicable resolution.
 Communicate with the providers to solve out, payment issues, Clint issues, agreement conditions.
 Manage, organise and update relevant data using database application to ensure integrity of reference data.
 Organize the work and give support to relationship team.

Senior Customer Service at Bupa Arabia
  • Saudi Arabia - Jeddah
  • August 2007 to March 2010

Track record in handling complicated tasks in the department, which is already meant to be handled by the mentors and team leaders (Fraud- Anti selection cases).
Providing quality customer service on every incoming & outgoing call. (Classified as No. 1 achiever based on Best Quality in November 2008).
Insure that all written and verbal complaints are being handled according to the complaint handling process.
Follow up and use proper escalation with / to other departments for proper resolution related to complex cases.
Taking the leadership of handling critical issues provided by the direct & the processing manager.

Sales - Business Owner at Al Mimas Est
  • Saudi Arabia - Jeddah
  • July 2005 to July 2007

This was my first experience to run my own business. I was importing industrial equipments, maintaining convenient stock, and selling the product to the retailers and wholesalers.

Assistant Accountant at AL_Nizami Est.
  • Saudi Arabia - Jeddah
  • May 2004 to June 2005

Processing of all accounts receivable and payable
Reconcile bank balances, record general ledger entries
Collecting due payments from client
Establish customer credit lines and set up credit accounts with vendors

Assistant Accountant at Al-Nileen Est
  • Saudi Arabia - Jeddah
  • May 2001 to April 2004

Performed general sales, Marketing and Promotional tasks
Formulated contracts with vendors and client Organized and controlled inventory
Performed purchasing duties
Collecting due payments from client

Education

Bachelor's degree, Marketing
  • at Yemen University of Science & Technology
  • July 2008

Graduated

Specialties & Skills

Marketing
Customer Service
Provider Relations
Insurance
Decision Making Skills
Word,Excel,Powerpoint,,outlook.
Advance negotiation skills (course)
IFCE -  Insurance Foundation Certificate Exam (certified course by SAMA)
Communication and influencing workshop (course)
Analytical thinking & Problem solving (course)
Problem solving & decision making (course)
Time management (course)

Languages

English
Intermediate
Arabic
Expert