Summary
Date Posted: Wednesday, June 01, 2022 , Base Salary: Not Disclosed

JOB DETAILS:
Job Purpose and Key responsibilities
Reporting to the Team Leader Corporate Care, the role holder will provide guidance on all matters relating to cost management, provider on-boarding, provider relationship and provider audit process.

Key responsibilities
• Supervise relationship management with providers to ensure providers are satisfied with 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 service level agreements.
• Price guided tariffs- building of provider pricelists especially for bigger providers on average pharmaceutical expenditure.
• Monitoring Average Costs of providers and engaging high-cost providers to reduce unnecessary expenditure.
• Supervision of provider audits to ensure that quality, cost effective medical services.
• Supervision of the contracting process and ensure that all providers have active and updated contracts.
• Ensure compliance with to any regulatory or health sector changes, such as billing and payment requirements.
• Any other duties assigned by the Team Leader Corporate Care division.
Key Performance Measures
• Saving the company money from wastage and exorbitant fees by providers.
• Medical fraud mitigation
• System support and integration on CPT coding

Knowledge, experience and qualifications required
• Diploma, Degree in Nursing or Diploma in clinical Medicine or Diploma in Pharmacy
• Moderate understanding of Insurance concepts
• Professional qualification in FLMI,ACII and IIK
• 3-5 years’ experience in provider management

Emerging Leaders in Britam need to:
• Plan, direct and apply efficiencies and resources in order to optimise output and profitability against time, cost and team targets;
• Effectively communicate strategic and operational departmental goals and objectives to peers and others in order to ensure proper implementation;
• Ensure that department priorities are adhered to and effectively communicated;
• Ensure competent and effective people resources through appropriate coaching, development and people supervision as appropriate;
• Embody a high performance, proactive culture;
• Effectively ensure the adherence to key performance areas, deadlines and goals in order to optimise operational effectiveness;
• Effectively communicate resource needs, possible opportunities and achievements to management in order to aid them in their decision-making;
• Effectively set and monitor priorities and objectives for more junior staff;
• Understand and communicate objectives in relation to the larger organisational impact;
• Effectively disseminate knowledge within the correct context, towards subordinates as well as management;
• Appropriately model the company values while setting the pace and energy for delivering;
• Effectively manage and communicate change within the department in order to increase staff and process effectiveness;
• Provide access to accurate and consistent information and services across all channels;
• Ensure a seamless experience for clients;
• Improve service delivery for clients;
• Engage in continuous brand building to become the trusted partners to clients.
Emerging Leaders Competency Descriptions.
• Presenting and Communicating Information - Speaks fluently; expresses opinions, information and key points of an argument clearly; presents effectively; responds quickly to others ‘reactions and feedback during conversations; projects credibility.
• Working with People - Shows respect for the views and contributions of team members; shows empathy; listens, supports and cares for others; consults others and pro-acitvely shares information and expertise with them; builds team spirit and reconciles conflict; adapts to the team and fits in well.
• Adhering to Principles and Values - Upholds and encourages ethical behavior and departmental values; demonstrates integrity; encourages individual responsibility towards the community and the environment; models the organizational values during every day interactions.
• Analyzing - Analyses numerical data and all other sources of information, breaking them into component parts, patterns and relationships; probes for further information or greater understanding of a problem; makes rational judgments from the available information and analysis; demonstrates an understanding of how one issue may be part of a much larger system / process / problem.
• Planning and Organizing - Adheres to and monitors clearly defined objectives; plans activities and projects well in advance and takes account of possible changing circumstances; identifies and organizes resources needed to accomplish tasks; manages time effectively; monitors performance against deadlines and milestones.
• Delivering Results and Meeting Customer Expectations - Focuses on customer needs and satisfaction; sets and models high standards for quality and quantity; monitors and maintains quality and productivity; works in a systematic methodical and orderly way; consistently achieves projects goals.
• Deciding and Initiating Action - Takes responsibility for own, as well as subordinates’ actions and projects; takes initiative and works under own direction; initiates and generates activity; introduces improvements into work processes; handles problems with minimal guidance.
• Leading and Supervising - Provides subordinates with a clear direction; motivates and empowers others; provides subordinates with the relevant coaching; creates a positive climate that fosters learning and development; identifies high potential talent; sets and articulates the departmental vision and values through own personal behavior; sets appropriate standards of behavior.
• Formulating Strategies and Concepts - Works strategically to realize personal goals; understands and effectively communicates the departmental strategy; translates the departmental strategy and vision into operational responsibilities; takes into consideration departmental strategy during all tasks; takes account of a wide range of issues across, and related to current role.
• Applying Expertise and Technology - Applies specialist and detailed technical expertise; uses technology to achieve work objectives; develops job knowledge and expertise (theoretical and practical) through continual professional development; demonstrates an understanding of different organizational departments and functions.
• Following Instructions and Procedures - Challenges authority only when appropriate; follows procedures and policies; keeps to schedules; arrives punctually for work and meetings; demonstrates a commitment to the organization; complies with legal obligations and safety requirements of the role.
• Adapting and Responding to change - Adapts to changing circumstances; tolerates ambiguity; accepts new ideas and change initiatives; adapts interpersonal style to suit different people or situations; shows an interest in new experiences.


Work Hours: 8

Experience in Months: 36

Level of Education: Associate Degree

Job application procedure
Interested and qualified? Go to Britam on britam.taleo.net to apply

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