Provider Partnerships Executive at Jubilee Insurance

Job Reference Number: HRJIC606

Role Purpose

We currently have an exciting career opportunity for Provider Partnerships Executive, Jubilee Health Insurance Limited (JHIL). The position holder will report to the Senior Provider Partnerships Executive and will be based at Head Office in Nairobi.

Role Purpose
The job holder will develop, manage, and sustain relationships with healthcare provider networks to secure high-quality and cost-effective health care services. The main goal is to shape a comprehensive and integrated health care system by fostering a seamless and efficient service network.

Main Responsibilities

1. Relationship Management of providers and ensuring they are reasonably satisfied with the company.
2. Assist in obtaining the current provider information, to update the Jubilee Insurance Panel for various products.
3. Participate in collection of provider charges to facilitate negotiation of prices for the services rendered by providers.
4. Analysis of provider costs, claims, and provide data to inform decision making in scheme cost controls.
5. Ensuring all current and upcoming providers have signed contracts and have submitted all relevant documentation, carrying out system updates and filing of all relevant provider KYC documents.
6. Assist in carrying out country-wide provider audits to ensure that quality and cost-effective medical services are guaranteed for our clients.
7. Client presentation and member education on wise benefit utilization and risk management.
8. Provide guidance to the care management team, claims team and contact center agents on provider issues.
9. Work closely with the Claims Manager and Operation Manager on provider relation matters.
10. Support the business development and underwriting team in client servicing.

Key Competencies

1. Market Awareness
2. Customer Focus
3. Continuous Innovation
4. Ownership & Commitment
5. Team Spirit

Functional Skills

1. Excellent data analytical skills
2. Performance reporting and management.
3. Relationship Building skills
4. Personal Network Development

Qualifications

1. Diploma in Nursing/Clinical Medicine or any other related diploma
2. Good understanding of the concepts of medical insurance
3. Proficient in the use of Microsoft office suite and packages

Relevant Experience

Minimum of 2 years’ experience in the clinical practice. Relevant experience in the provider management.