Summary
Date Posted: Monday, June 13, 2022 , Base Salary: Not Disclosed

JOB DETAILS:
Role Purpose
• To coordinate negotiation of medical costs with providers.

Main Responsibilities
• Negotiation of cost of services rendered by medical providers.
• Monitoring Average Costs of providers and engaging high-cost providers for cost reduction.
• Engage providers on improving medical outcomes and quality of care.
• Liaising with providers where validity of services rendered does not conform with policy provisions, provider panel rules and acceptable medical practice.
• Coordinate the strategic purchasing team to deliver set targets.
• Provide guidance to the care management team, claims team, and contact center agents on provider and claims issues.
• Participates in Provider Partnership Committee meetings for accreditation of new providers and rationalization of existing providers.
• Relationship Management with providers and ensuring providers are reasonably satisfied with the company.
• Support in conducting of regular training of care management team, claims team and contact center agents on medical procedures or latest treatment protocols where knowledge gaps are identified.
• Support the business development and underwriting teams in client servicing.
• Interacting with clients, brokers and clinicians as needed, to resolve problems in a manner that is legal, ethical, and consistent with the principles of the policy.

Functional Skills
• Health benefits plan Management
• Negotiation
• Supervision
• New ideas generation
• Excellent analytical skills
• Performance reporting and management
• Training supervision and management

Qualifications
• Diploma in Nursing/Diploma in Clinical Medicine & Surgery
• Basic understanding of the concepts of insurance
• Proficient in the use of Microsoft office suite and packages.


Job Experience: No Requirements

Work Hours: 8

Level of Education: Postgraduate Degree

Job application procedure

• If you are qualified and seeking an exciting new challenge, please apply via Recruitment@jubileekenya.com  quoting the Job Reference Number and Position by 19th June 2022

• Only shortlisted candidates will be contacted


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