Vacancies at Liberty Life

Job Summary

The role is responsible for data analysis and preparation of reports for risk assessment, quarterly scheme management reports and other periodic / adhoc reports to provide insights and enrich the decision-making process for the business.

Key Responsibilities

• Scheme management reports
• Scheme benefit utilization reports
• Portfolio loss ratio reports
• Monthly paid claims / utilization analysis
• Monthly membership reconciliation across the various systems
• Claims updates on Smart for off smart claims for clients on member certificates.
• Create dashboards for the various health business functions.
• Other reports / analysis required by the business

Qualifications

• Bachelor’s degree in Data Science/ Data Analytics or Actuarial Science. 
• Other related certifications will be an added advantage.

Experience

• 2 years’ experience in the data analytics field in the medical insurance or related industry

Competencies

• Good analytical and report preparation skills

• Excellent communication skills
• Wide knowledge on data analytic tools and developments in the field
• Enhanced skills on use of MS Office and other office applications
• Understanding of health insurance operations and concepts
• Stakeholder management
• Customer service
• Delivering results and meeting customer expectations
• Coping with pressures and setbacks
• Analyzing
• Working with people
• Adapting and responding to change
• Planning and organizing
• Presenting and communicating information
• Learning and researching
• Adhering to principles and values
• Achieving personal work goals and objectives

go to method of application »

Job Summary

• The role is responsible for Servicing providers management, contracting, accreditation, and audits

Key Responsibilities

• Maintain a cordial working relationship with providers within Heritage provider network.
• Accredit new service providers to meet the client’s needs/demands.
• Negotiate service fees upon contracting of new service providers, guided by the Heritage rates and customary fees.
• Coordinate provider audit to ensure quality services is accessed by Heritage clients.
• Enforce compliance to Heritage rules and procedures regarding member access, policy exclusions and panel rates.
• Coordinate with Underwriting/Actuarial & prepare monthly utilization report on performance of service providers and develop appropriate measures to contain cost.
• Proper documentation of all service provider contracts and ensure timely renewal and KYC updates as per the set guidelines.
• Train Service providers on heritage service access procedure/processes, update on any changes at Heritage in term of health products, existing processes and other related claim policies.
• Engage service providers in negotiation for discounts and close finance reconciliations.
• Liaise internally with other sections to ensure resolution of service provider-related issues.
• Regular update of the Heritage provider panel and timely sharing with relevant stakeholders.

Qualifications

• Bachelor’s Degree or Diploma in Nursing, Clinical Medicine, Pharmacy, or medical-related discipline

Experience

• 3 years’ experience in medical insurance/hospital or related industry

Competencies

• Understanding of health insurance operations and concepts
• Knowledge of medical claims processes and procedures
• Provider and stakeholder management
• Analytical skills, Customer service
• Delivering results and meeting customer expectations
• Coping with pressures and setbacks 
• Analysing
• Working with people
• Adapting and responding to change
• Planning and organizing
• Presenting and communicating information
• Learning and researching 
• Adhering to principles and values
• Achieving personal work goals and objectives