JOB DESCRIPTION



JOB DESCRIPTION

|TITLE: Manager Commercial |

|DIVISION: Health Services Group |AGREED |

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|JOB GROUP: Executive |..........................................................|

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| |Job Holder |

|DATE: February 2008 |AGREED |

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| |Immediate Manager |

JOB PURPOSE

The Manager Commercial is primarily responsible for the development of guidelines for health commercial services, and the negotiation and setting of fee schedules.

To develop agreements on behalf of Worksafe and the TAC that include client and injured worker outcome expectations and delivery.

ORGANISATIONAL RELATIONSHIPS

|Reports to |Senior Manager Commercial |

|Directly manages |Senior Health Purchasing Advisors x 1 |

|Internal contacts |Head, Health Services Group |

| |Director, Health Services Operations |

| |Senior Clinical Advisors – TAC/ Worksafe |

| |Senior Managers (Health, Claims, Legal, Finance) |

| |Agent & Claims staff |

| |Commercial Legal |

| |Government Relations Officer |

|External contacts |Health providers |

| |Hospital Executive |

| |Department of Human Services |

| |Professional associations |

| |Industry peak bodies |

| |Australian and international insurers |

DIMENSIONS/DELEGATION

|Number of direct/indirect reports |3 |

|Budget responsibility |Contracts $60M |

KEY ACCOUNTABILITIES

▪ Lead and manage the TAC and Worksafe health private hospital commercial programs, to ensure effective contractual management

▪ Lead and manage appropriate commercial synergies between Worksafe and the TAC

▪ Provide expert advice regarding health commercial matters to the Senior Manager Commercial

▪ Identify, lead and implement innovative purchasing programs, working cooperatively with claims, health and legal divisions

▪ Manage provider fee schedules to ensure effective liability control for TAC & Worksafe

▪ Manage procurement processes for the Health Services Group

▪ Develop and manage contracts with hospital third party health providers

▪ Simplify fee and reporting arrangements between the TAC, Worksafe and the healthcare marketplace.

▪ Maximise the contribution of the Fees and Guidelines team to the VWA strategy by ensuring clear understanding of team and individual goals, and developing the skills and composition of the wider HSG team to meet these goals.

▪ Identify, manage, and if appropriate escalate, potential risk or factors affecting scheme, RCBU or RMSD performance

▪ Provide specialist technical advice on the commercial purchasing

▪ Consultation with internal and external stakeholders and develop recommendations for fees and guidelines including financial analysis with particular emphasis on actuarial and scheme.

▪ Ensure a consistent approach to the development of guidelines through the design and management of a guidelines template.

▪ Develop consistent reporting processes for the performance measurement of agent and provider services, the impacts of fee and guidelines changes and the impact of interventions.

▪ establish methodology for performance measurement and the collection and analysis of data

KEY SELECTION CRITERIA

|SKILLS |Essential |Desirable |

|Knowledge and experience of purchasing in the health sector |x | |

|Strong conceptual, analytical and strategy setting skills |x | |

|Experience with financial analysis and modelling |X | |

|Highly developed written and verbal communication and negotiation skills |x | |

|Strong ability to prepare policy business papers with the ability to analyse complex |x | |

|information and to develop a relevant and robust business case | | |

|Strong negotiation skills with the proven ability to build , influence and represent the |x | |

|TAC and Worksafe with external stakeholders | | |

|Demonstrated ability for innovation in the provision and delivery of health services |x | |

|and/or claims insurance | | |

|Well developed interpersonal, relationship and people management skills |x | |

|Demonstrated ability in work and process planning |x | |

|KNOWLEDGE AND EXPERIENCE |Essential |Desirable |

|Relevant work experience |

|At least 5 years experience in a management role in the Health sector |x | |

|A demonstrated record of successful performance in innovative health strategy and business |x | |

|delivery | | |

|Relevant qualifications |

|Tertiary qualifications in a business, policy or health related discipline. |x | |

|Postgraduate qualifications in a business, policy or health related discipline |x | |

|Specialised knowledge |

|Knowledge and experience in acute and/or rehabilitation medicine |x | |

|Knowledge of the ACA (1985) & TAC (1986) | |x |

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