Job Ref. No. JHIL045

Role Purpose

Develop, manage, and sustain relationships with healthcare providers network to secure high-quality, cost-effective health care services.

Main Responsibilities

• Negotiation of cost of services rendered by medical providers.
• Monitoring Average Costs of providers and engaging high-cost providers for cost reduction.
• Preauthorization of pharmacy requests.
• Implement initiatives that help reduce the cost of drugs such as drug delivery, generic drugs utilization among others.
• Analysis of provider costs, claims, and provider data to inform decision making in cost controls
• Ensuring all cost Agreements have been Setup in the System, i.e., Copays, Discounts, Micro Schemes and Restricted Categories/Providers.
• Relationship Management with providers and ensuring providers are reasonably satisfied with the company.
• Assist in carrying out country-wide provider audits to ensure that quality, cost effective medical services can be guaranteed for clients
• Provide guidance to the care management team, claims team, and contact center agents on provider cost issues.
• Support the business development and underwriting team in client servicing.

Key Competencies

• Negotiation
• Performance reporting and management.
• Relationship Building skills
• Health Benefit Plan Management

Functional Skills

• Market Awareness
• Customer Focus
• Negotiation
• Continuous Innovation
• Ownership & Commitment
• Team Spirit

Qualifications

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

Method of Application

If you are qualified and seeking an exciting new challenge, please apply via [email protected] quoting the Job Reference Number and Position by 10th October 2022 Only shortlisted candidates will be contacted.