Provider Liaison Officers – Medical Scheme - Pretoria
Growthlink Consulting
Pretoria, South Africa
5d ago
source : Executive Placements

Provider Liaison Officers Medical Scheme - Pretoria

The Provider Liaison Officers will be required to provide support to the Senior Manager : Networks and Provider Relations through the implementation of the following Key Performance Areas (KPAs) :

ü Support the Senior Manager : Networks and Provider Relations in maintaining the organisations relationship with healthcare providers within assigned region

ü Participate in the review and submission of organisations networks reports

ü Support the Senior Manager : Networks and Provider Relations in the management of the Managed Care Organisations that are contracted by the Scheme

ü Participate in the review of the providers efficiency reports

ü Provide substantiated commentary on the quality of network services and provider compliance to the Scheme network agreements

ü Represent the Healthcare Management Division at SPN and Stakeholder Engagements and promote network participation by healthcare providers

ü Provide periodic reports relating all stakeholder engagements to the Senior Manager : Networks and Provider Relations

ü Ensure continuous education on organisations strategy, systems, processes and product to the relevant providers within the assigned region

ü Serve as a single point of contact for escalations related to claims and authorizations issues from the providers within the assigned region.

ü Perform a secretariat function for the provider relations engagements

ü Support other Scheme Divisions in managed care activities

ü Fulfil various stakeholder engagements as directed by the Chief Healthcare Officer

Requirements :

ü At least a 3year Diploma / Degree or equivalent NQF level in Clinical Sciences related fields

ü At least 5 years work experience in the healthcare funding / medical scheme industry

ü Must have experience in provider relations management

ü Experience in case / claims management will be advantageous

ü Must have experience in the development and presentation of management reports

ü Computer literacy and MS Office skills

ü Sound Quantitative and qualitative analysis skills with ability to manage priorities

ü Have diligent work ethics with attention to detail

ü Excellent communication and writing skills

ü Have ability to work well as part of a team

ü Be responsible and reliable

ü Have sound planning / project management skills

ü Be a self-starter

ü Own transport essential

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