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
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