Job Summary
The individual in this position will oversee the management of service providers, including contracting, accreditation, and audit processes.
Key Responsibilities
Cultivate positive and collaborative professional relationships with healthcare providers affiliated with the Heritage Insurance network.
Evaluate and formally recognize new service providers to ensure they fulfill the client’s specified requirements and expectations.
Upon entering into agreements with new service providers, determine service fees in alignment with Heritage Insurance’s established rates and prevailing industry standards.
Coordinate provider audits to verify that Heritage Insurance clients receive high-quality services, ensuring standards of care and compliance are met.
Ensure strict adherence to Heritage guidelines and protocols concerning member access, policy exemptions, and panel pricing structures.
Collaborate closely with Underwriting and Actuarial teams to compile and analyze monthly utilization reports, assessing the performance of service providers and identifying cost containment opportunities.
Accurately maintain comprehensive records of all service provider contracts and oversee their timely renewal while ensuring KYC (Know Your Customer) updates are completed in accordance with established guidelines.
Provide comprehensive training programs for Service Providers on the Heritage Insurance service access procedures and processes, ensuring awareness of any modifications to health products, current processes, and related claim policies at Heritage Insurance.
Negotiate favorable terms and pricing with service providers to secure discounts, while ensuring seamless completion of financial reconciliations.
Work collaboratively with other departments to address and resolve issues related to service providers, ensuring seamless communication and coordination across teams.
The Heritage Insurance provider panel is updated regularly and shared promptly with all pertinent stakeholders to ensure ongoing accuracy and transparency.
Bachelor’s degree in Computer Science, Information Technology, or a related field is required. Minimum of three years of experience in software development is essential, with proficiency in programming languages such as Java, Python, or C#. Strong problem-solving skills and the ability to work independently or in a team setting are necessary. Experience with database management and familiarity with Agile methodologies are preferred. Excellent communication and organizational abilities are crucial for collaborating with cross-functional teams and delivering projects on schedule.
A bachelor’s degree or diploma in Nursing, Clinical Medicine, Pharmacy, or a related medical field is required.
Experience
With a minimum of three years of hands-on experience in provider relations within the medical insurance, hospital, or related sectors, candidates should demonstrate a proven track record in this field.
Seeking a highly skilled professional with expertise in specific competencies to drive organizational success. The ideal candidate will possess a proven track record in strategic planning, project management, and team leadership, ensuring alignment with company objectives. Proficiency in data analysis, problem-solving, and stakeholder communication is essential to excel in this role. Additionally, the candidate must demonstrate strong adaptability, innovation, and a commitment to continuous improvement. Responsibilities include overseeing cross-functional initiatives, optimizing processes, and fostering a collaborative work environment. The successful applicant will be expected to meet deadlines, manage resources effectively, and contribute to long-term growth strategies.
Skilled in communicating effectively and negotiating with stakeholders to achieve mutually beneficial outcomes.
Analytical abilities of a high standard are required for this role, enabling the evaluation of complex information to derive meaningful insights. The incumbent will employ structured methodologies to dissect data, identify patterns, and resolve intricate problems efficiently. Proficiency in interpreting quantitative and qualitative information is essential to support informed decision-making and strategic planning within the organization.
Proficient in utilizing Microsoft Office suite and Excel applications with a strong command of their functionalities.
Proven expertise in comprehending provider dynamics and the broader healthcare landscape is required.
Cost optimization strategies encompass systematic approaches to reduce expenses and enhance operational efficiency across various business functions. These strategies involve analyzing current expenditures, identifying inefficiencies, and implementing targeted solutions such as process automation, vendor negotiations, and resource reallocation. Additionally, they require continuous monitoring and adjustment to ensure sustained financial performance and alignment with organizational goals.
If you satisfy the specified criteria, kindly submit your application along with an updated CV to vacancies@heritage.co.ke by June 7, 2026, ensuring the job title is clearly indicated in the subject line. Liberty Kenya is committed to equal opportunity employment and values diversity in its workforce. Kindly note that only candidates selected for further consideration will be notified. The personal data provided will be utilized exclusively for recruitment purposes, in compliance with the privacy statement available on our website at https://www.liberty.co.ke.
Qualifications
BA/BSc/HND , Diploma
Experience Required
3 years
