Provider Partnerships Executive
Nairobi
FullTime
Office
Available Slots
1
Compensation:$ to $
Application open Till: 2022-11-01 15:00:00
Job Summary
Role Purpose Develop
manage, and sustain relationships with healthcare provider’s network to secure high-quality, cost-effective health care services.
Job Description
Main Responsibilities
- Relationship Management with providers and ensuring providers are reasonably satisfied with the company.
- Participate in formation of strategic partnerships with service providers through various incentives and initiatives that motivates the providers to be advocates of the company.
- Regular updating of the Jubilee Insurance Provider Panel and timely sharing with clients.
- Provider onboarding and accreditation of service providers within set timelines to ensure that quality and affordable providers are contracted by the company.
- Participate in collection and system updates of provider KYC and licenses to ensure compliance to any regulatory or health sector changes e.g., changes in the health legislation affecting the business
- Analysis of provider costs, claims, and provide data to inform decision making in scheme cost controls
- Ensuring all newly on boarded and existing Jubilee Health insurance panel of providers have duly executed contracts.
- Assist in carrying out country-wide provider audits to ensure that quality, cost effective medical services can be guaranteed for clients.
- Liaising with providers where validity of services rendered does not conform with policy provisions, provider panel rules and acceptable medical practice
- Client presentation and member education on wise benefit utilization and risk management.
- Provide guidance to the care management team, claims team, and contact center agents on provider issues.
- Support the business development and underwriting team in client servicing.
Key Competencies
- Market Awareness
- Customer Focus
- Continuous Innovation
- Ownership & Commitment
- Team Spirit
Functional Skills
- Excellent data analytical skills
- Performance reporting and management.
- Relationship Building skills
Qualifications
- Diploma or bachelor’s degree in Nursing or Clinical Medicine
- Good understanding of the concepts of medical insurance
- Proficient in the use of Microsoft office suite and packages