Reporting to the Team Leader Corporate Care Management, the role holder will be responsible for effective provider management to enhance cost saving measures, customer engagement and provider relationship.
Review provider applications and contracts.
Negotiate rates with providers in line with Britam Cost saving strategy.
Relationship Management of providers and ensuring they are reasonably satisfied with the company.
Update provider panel/Contacts to ensure the list is current and up to date.
Analysis of provider costs, claims, and provide data to inform decision making in scheme cost controls.
Ensuring all current and upcoming providers have signed contracts and have submitted all relevant documentation, carrying out system updates and filing of all relevant provider KYC documents.
Assist in carrying out country-wide provider audits to ensure that quality and cost-effective medical services are guaranteed for our clients.
Provide guidance to the care management team, claims team and contact center agents on provider issues.
Knowledge, experience and qualifications required:
Diploma in Nursing/Clinical Medicine or any other related diploma.
Good understanding of the concepts of medical insurance.
2-4 years’ experience in provider management (Doctors and Hospitals).
Proficient in the use of Microsoft office suite and packages.
Technical/ Functional competencies:
Excellent communication, negotiation and interpersonal skills.
Excellent analytical and monitoring skills.
High level of integrity and honesty.
Team player, commitment and ownership.
Empathy and Customer Focus.
Basic understanding of health insurance.
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