Senior Strategic Purchasing Executive at Jubilee Insurance

Role Purpose

To coordinate negotiation of medical costs with providers.

Main Responsibilities

1. Negotiation of cost of services rendered by medical providers.
2. Monitoring Average Costs of providers and engaging high-cost providers for cost reduction.
3. Engage providers on improving medical outcomes and quality of care.
4. Liaising with providers where validity of services rendered does not conform with policy provisions, provider panel rules and acceptable medical practice.
5. Coordinate the strategic purchasing team to deliver set targets.
6. Provide guidance to the care management team, claims team, and contact center agents on provider and claims issues.
7. Participates in Provider Partnership Committee meetings for accreditation of new providers and rationalization of existing providers.
8. Relationship Management with providers and ensuring providers are reasonably satisfied with the company.
9. 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.
10. Support the business development and underwriting teams in client servicing.
11. 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

1. Health benefits plan Management
2. Negotiation
3. Supervision
4. New ideas generation
5. Excellent analytical skills
6. Performance reporting and management
7. Training supervision and management

Qualifications

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