JOB TITLE: Provider Relations Officer
Your time is now to be your exceptional best at Old Mutual!
The job holder will be responsible for managing the UAP Provider Network in Tanzania and act as the Health business liaison for Head Office while ensuring superior customer experience.
KEY TASKS & RESPONSIBILITIES
- Provider contracting – contract medical service providers in Tanzania and manage the contract lifecycle.
- Provider network management – maintain an up to date provider panel, monitor adequacy of providers in all key regions.
- Conduct provider audits and Quality Assurance
- Provider relationship management – organize service meetings, training on UAPOM processes, obtain provider feedback and share relevant reports on providers
- Provider engagement and negotiation of rates for contracted services
- Attend client service meetings and ensure delivery of superior customer experience
- Support in business prospecting and business acquisition
- Support business processing in tracking membership and card distribution issues
- Support case management and assist in claims verification prior to settlement
- Assist in claims processing and reconciliation with providers
- Promptly respond to queries from providers, clients and intermediaries
- Proactively escalate any identified risks or risk events
- Any other duty assigned by management
SKILLS AND COMPETENCIES
- Excellent communication and negotiation skills.
- Excellent interpersonal relationship skills.
- Extensive networking with SP and other medical insurers.
- Excellent analytical and monitoring skills
- Good decision-making skills
- High level of integrity and honesty
QUALIFICATIONS, KNOWLEDGE AND EXPERIENCE
- Diploma/Bachelor in a Clinical or Business field
- At least 2 years’ relevant experience in health insurance in Tanzania
- Extensive knowledge of public and private healthcare providers in Tanzania
- Experience in a busy hospital setting in Tanzania will be preferred
- Any insurance certification will be an added advantage
9 July 2021