Contract Governance Manager

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. Roles and Responsibilities 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 processesFunctional Accountabilities Develop and implement contract governance policies, procedures, and standardsEstablish 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 Requirements: Key Contacts 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. Job Qualifications and Requirements Knowledge and Experience 8–11 years of experience in healthcare contracting, RCM, or financial governanceMinimum 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 platformsEducation 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 skillsAnalytical 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 Reven

Establish and maintain contract governance frameworks across all payer agreements; ensure compliance with CCHI regulations, NPHIES standards, and internal policies; enhance revenue integrity by proper implementation and monitoring of contract terms; minimize financial, legal, and operational risks; standardize and ensure consistency of contract management practices; support audit readiness and regulatory compliance; develop and implement contract governance policies, procedures, and standards; establish contract lifecycle management processes; define roles, responsibilities, and approval matrices; ensure all contracts comply with healthcare laws and payer requirements; align contracts with NPHIES workflows and digital health requirements; monitor regulatory changes and update contracts; oversee contract implementation and system configuration in HIS and billing systems; interpret and apply contract terms across RCM functions; monitor adherence and identify deviations; identify risks of contract gaps, pricing errors, or misinterpretation; implement controls to prevent revenue leakage; conduct regular contract audits and compliance reviews; develop dashboards and KPIs; analyze reimbursement trends and payer performance; provide insights to senior management; act as governance liaison between RCM, Finance, Legal, and Commercial; coordinate with payer contracting teams and external stakeholders; provide guidance and training on contract governance; maintain centralized contract repository with version control and audit trails; ensure accessibility and security of records; identify opportunities to automate processes; support implementation of contract management systems; enhance efficiency and control through digital tools and analytics.