Provider Partnerships Executive at Gelian Hotel Machakos

Main Responsibilities

• Relationship Management with providers and ensuring providers are reasonably satisfied with the company.
• Participate in formation of strategic partnerships with service providers through various incentives and initiatives that motivates the providers to be advocates of the company.
• Regular updating of the Jubilee Insurance Provider Panel and timely sharing with clients.
• Provider onboarding and accreditation of service providers within set timelines to ensure that quality and affordable providers are contracted by the company.
• Participate in collection and system updates of provider KYC and licenses to ensure compliance to any regulatory or health sector changes e.g., changes in the health legislation affecting the business
• Analysis of provider costs, claims, and provide data to inform decision making in scheme cost controls
• Ensuring all newly on boarded and existing Jubilee Health insurance panel of providers have duly executed contracts.
• Assist in carrying out country-wide provider audits to ensure that quality, cost effective medical services can be guaranteed for clients.
• Liaising with providers where validity of services rendered does not conform with policy provisions, provider panel rules and acceptable medical practice
• Client presentation and member education on wise benefit utilization and risk management.
• Provide guidance to the care management team, claims team, and contact center agents on provider issues.
• Support the business development and underwriting team in client servicing.

Key Competencies

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

Functional Skills

• Excellent data analytical skills
• Performance reporting and management.
• Relationship Building skills

Qualifications 

• Diploma or bachelor’s degree in Nursing or Clinical Medicine
• Good understanding of the concepts of medical insurance 
• Proficient in the use of Microsoft office suite and packages