Job Ref. No: JHIL066
Role Purpose
To supervise and provide guidance on all matters relating to cost control management, provider onboarding, contracting and strategic relationship management.
Main Responsibilities
Supervise tiered relationship management with providers and ensuring providers are reasonably satisfied with the company.
Facilitate formation of strategic partnerships with service providers through various incentives and initiatives that motivates the providers to be advocates of the company.
Analysis of customer feedback surveys, provider complaints and compliments to inform decision making in provider experience.
Strategic cost control engagements with providers and monitoring adherence to the agreements.
Negotiation of prices for all billable services rendered by providers.
Monitoring Average Costs of providers and engaging high-cost providers to reduce unnecessary expenditure
Supervision of country-wide provider audits to ensure that quality, cost-effective medical services can be guaranteed for clients.
Participate in Provider Partnership Committee meetings for accreditation of new providers and rationalizationof existing providers.
Supervision of provider onboarding process to ensure that the same is done within the set timelines.
Supervision of the contracting process and ensure that all health service providers have contracts and have all required compliance documents.
Supervise regular updating of the Jubilee Health Insurance provider panel for various products and timely sharing with clients.
Providing technical and Operational supportto all internal and external stakeholders i.e., Claims Department, Business
Development, Clinical Operations, regional office, third party administrators, brokers on provider relationmatters.
Ensure compliance to any regulatory or health sector changes e.g., changes in billing/payments requirements, changes in the health legislation affecting the business.
Any other ad hoc duties as assigned by the company from time to time.
Key Competencies
Health benefits plan Management
New ideas generation
Excellent analytical skills
Performance reportingand management
Training supervision andmanagement
Qualifications
Bachelors Science degree in Nursing/Clinical Medicine & Surgery
Basic understanding of the concepts of insurance
Proficient in the use of Microsoft office suite and packages
Experience in Claims Processing is an added advantage
Relevant Experience
At least five (5) years in Clinical Practice in the insurance industry
Relevant experience in Provider Management and/or Care Management
Closing: 5th April, 2023
go to method of application »
If you are qualified and seeking an exciting new challenge, please apply via Recruitment@jubileekenya.com quoting the Job Reference Number and Position
Apply via :
Recruitment@jubileekenya.com
