Contract Governance Manager

Position Overview

We are seeking a highly motivated and detail-oriented Contract Governance Manager to oversee the development, implementation, and continuous improvement of governance frameworks for payer contracts. In this pivotal role, you will ensure that all contractual agreements align with regulatory requirements, operational standards, and financial objectives, while safeguarding revenue integrity, mitigating risks, and enhancing organizational transparency. Your expertise will be instrumental in maintaining compliance with CCHI regulations, NPHIES standards, and internal policies, as well as driving efficiency and accountability across the contract lifecycle.

Key Responsibilities

The Contract Governance Manager will play a critical role in establishing and maintaining robust governance structures to support payer contracts. Your responsibilities will include:

• Governance Framework Development: Design, implement, and maintain comprehensive contract governance frameworks that ensure compliance with CCHI regulations, NPHIES requirements, and internal policies. Establish standardized processes for contract creation, approval, renewal, and termination to enhance consistency and control.
• Regulatory Compliance and Risk Management: Monitor regulatory changes and ensure that all contracts are updated accordingly to mitigate legal, financial, and operational risks. Conduct regular audits and compliance reviews to identify gaps, pricing errors, or misinterpretations that may impact revenue integrity.
• Revenue Integrity and Financial Optimization: Oversee the accurate interpretation and application of contract terms across Revenue Cycle Management (RCM) functions. Implement controls to prevent revenue leakage and ensure correct reimbursement, while analyzing reimbursement trends and payer performance to drive financial optimization.
• Stakeholder Collaboration and Communication: Serve as the primary governance liaison between RCM, Finance, Legal, Commercial, and IT teams. Coordinate with internal and external stakeholders, including insurance companies, TPAs, CCHI, and NPHIES platform stakeholders, to ensure seamless contract management and alignment with organizational goals.
• Contract Lifecycle Management: Develop and maintain contract lifecycle management processes, including role definitions, approval matrices, and system configurations in HIS and billing platforms. Ensure proper version control, audit trails, and documentation standards to support transparency and accountability.
• Performance Monitoring and Reporting: Create and maintain dashboards and KPIs to monitor contract performance, compliance, and financial outcomes. Provide actionable insights and recommendations to senior management to support strategic decision-making and continuous improvement.
• Process Automation and Digital Transformation: Identify opportunities to automate contract management processes and enhance efficiency through digital tools and analytics. Support the implementation of contract management systems and ERP/HIS platforms to streamline operations and improve control.

Qualifications and Requirements

To excel in this role, you will bring a blend of healthcare contracting expertise, governance acumen, and leadership experience. The ideal candidate will possess the following qualifications:

• Professional Experience: A minimum of 8–11 years of experience in healthcare contracting, Revenue Cycle Management (RCM), or financial governance, with at least 3–5 years in a governance, managerial, or leadership capacity. Strong expertise in payer contracts and contract lifecycle management is essential.
• Regulatory Knowledge: In-depth understanding of CCHI regulations, Saudi insurance frameworks, and NPHIES workflows. Familiarity with healthcare laws and compliance frameworks is highly desirable.
• Financial and Operational Skills: Proven ability to implement financial controls, conduct audits, and ensure compliance with contractual terms. Experience in analyzing reimbursement trends, identifying variances, and optimizing financial outcomes is a key asset.
• Technical Proficiency: Hands-on experience with contract management systems, ERP platforms, and HIS systems. Knowledge of digital health ecosystems and claims processing workflows is beneficial.
• Education and Certifications: A Bachelor’s degree in Healthcare Administration, Law, Finance, Business Administration, or a related field is required. A Master’s degree in Business Administration (MBA) or Healthcare Management is preferred. Professional certifications such as CPA, CMA, SOCPA, or Contract Management Certification are advantageous.
• Soft Skills: Exceptional analytical, communication, and leadership skills. Ability to collaborate effectively with cross-functional teams, manage stakeholders, and drive process improvements in a dynamic healthcare environment.

If you are a strategic thinker with a passion for governance, compliance, and financial integrity, we invite you to apply and contribute to our mission of delivering excellence in healthcare contract management.