Current jobs related to Provider Relationship Specialist - Johannesburg, Gauteng - Kaelo

  • Debt Recovery Specialist

    2 weeks ago

    Johannesburg, Gauteng, South Africa Cool Ideas Service Provider Full time

    Cool Ideas Service Provider is seeking a highly skilled Debt Recovery Specialist to join our team.Key Responsibilities:Monitor and update reports and software systems to ensure accurate debt collection data.Maintain internal controls to prevent unauthorized access to debtor accounts.Oversee all debtor collections and ensure timely payment processing.Follow...

  • Relationship Banker

    2 weeks ago

    Johannesburg, Gauteng, South Africa Performability Full time

    At Performability, we are seeking a skilled Business Banking Specialist to join our team. The ideal candidate will have experience in the SME market and a proven track record of success in building and maintaining relationships with clients.Job PurposeThe successful candidate will have experience in Business Banking in the SME market, with a strong...

  • Client Relationship Specialist

    3 weeks ago

    Johannesburg, Gauteng, South Africa Performability Full time

    At Performability, we are seeking a skilled Business Banking professional to join our team as a Relationship Banker. The ideal candidate will have experience in the SME market and a proven track record of success in building and maintaining relationships with clients.Job PurposeThe successful candidate will have experience in business banking in the SME...

  • Carpentry Specialist

    2 weeks ago

    Johannesburg, Gauteng, South Africa Zeebra Junction Specialist Recruitment Full time

    {"h1": "Carpenter / Cabinet Maker Job Opportunity at Zeebra Junction Specialist Recruitment", "p": "We are seeking a skilled Carpenter / Cabinet Maker to join our in-house Maintenance Team at a large Function, Event and Conference Venue in Johannesburg. The successful candidate will report directly to the Property Managers and be responsible for fabrication,...

  • Debt Recovery Specialist

    7 days ago

    Johannesburg, Gauteng, South Africa Cool Ideas Service Provider Full time

    Debtors Clerk Job DescriptionCool Ideas Service Provider is seeking a skilled Debtors Clerk to manage our customer accounts and ensure timely payments.Key Responsibilities:Monitor and update reports and software systems to ensure accurate debt collectionMaintain internal controls and ensure compliance with debtor categoriesOversee all debtor collections and...

  • Fundraiser - Partnership Coordinator

    6 days ago

    Johannesburg, Gauteng, South Africa Zeebra Junction Specialist Recruitment Full time

    Job Title: Fundraiser - Partnership CoordinatorZeebra Junction Specialist Recruitment is seeking a highly skilled and motivated Fundraiser - Partnership Coordinator to join our team. As a key member of our fundraising team, you will be responsible for developing and implementing strategic partnerships to drive fundraising efforts and support the growth of...

  • Relationship Manager

    4 days ago

    Johannesburg, Gauteng, South Africa Bidvest Bank Full time

    {"title": "Business Banking Relationship Manager", "description": "Job SummaryWe are seeking a highly skilled Business Banking Relationship Manager to join our team at Bidvest Bank. As a key member of our sales team, you will be responsible for building and maintaining strong relationships with our clients, identifying new business opportunities, and...

  • Relationship Manager

    2 weeks ago

    Johannesburg, Gauteng, South Africa Bidvest Bank Full time

    {"Job Title": "Relationship Manager", "Job Description": "Job SummaryBidvest Bank is seeking a skilled Relationship Manager to join our team. As a Relationship Manager, you will be responsible for building and maintaining strong relationships with our clients, identifying new business opportunities, and providing exceptional customer service.Key...

  • FTTB Sales Representative

    2 weeks ago

    Johannesburg, Gauteng, South Africa Cool Ideas Service Provider Full time

    Cool Ideas Service Provider is seeking a dynamic and results-driven sales professional to join our Fibre to the Business (FTTB) Team. As a key member of our sales team, you will be responsible for driving sales growth and revenue in the Gauteng and Western Cape regions.**Key Responsibilities:**Develop and execute sales strategies to achieve monthly sales...

  • Fibre to Business Sales Representative

    6 days ago

    Johannesburg, Gauteng, South Africa Cool Ideas Service Provider Full time

    About the RoleCool Ideas Service Provider is seeking a highly motivated and results-driven Sales Agent to join our Fibre to the Business (FTTB) Team in Gauteng and Western Cape regions.Key Responsibilities:Engage in cold calling to identify new business opportunitiesClosing deals and managing client relationships to ensure satisfactionRequest quotes from...

  • Contract Specialist

    2 weeks ago

    Johannesburg, Gauteng, South Africa Easy Skill Full time

    Job SummaryWe are seeking a highly skilled Contract Specialist to join our team at Easy Skill. As a Contract Specialist, you will play a critical role in supporting the delivery of required contracts for goods and services to support mining-related activities.Key ResponsibilitiesSupport the Senior Contracts Specialist in the delivery of required contracts...

  • Relationship Manager: Heavy Haulage Specialist

    2 weeks ago

    Johannesburg, Gauteng, South Africa Santam Full time

    About the RoleWe are seeking a highly skilled and experienced Relationship Manager to join our team at Santam Heavy Haulage. As a key member of our business, you will be responsible for building and maintaining strong relationships with our brokers, driving business growth and retention through creative and attentive marketing, underwriting and risk...

  • AP Specialist

    2 weeks ago

    Johannesburg, Gauteng, South Africa Elite Search Full time

    About the RoleWe are seeking a highly motivated and detail-oriented AP Specialist to join our team at Elite Search. As an AP Specialist, you will play a critical role in managing our accounts payable process, ensuring timely and accurate payments to our vendors and suppliers.Key ResponsibilitiesManage and reconcile vendor invoices, ensuring accuracy and...

  • Customer Support Specialist

    2 weeks ago

    Johannesburg, Gauteng, South Africa ABC Worldwide Full time

    {"title": "Customer Support Specialist", "description": "Job SummaryAt ABC Worldwide, we are seeking a highly skilled Customer Support Specialist to join our team. As a key member of our customer support team, you will be responsible for providing exceptional support to our clients, ensuring their needs are met, and building strong relationships with our...

  • Credit & Collections Specialist

    3 weeks ago

    Johannesburg, Gauteng, South Africa Alfa Laval Full time

    About the CompanyAlfa Laval is a leading global provider of innovative solutions for the process industry, with a strong focus on customer satisfaction and quality.Job SummaryWe are seeking a highly motivated and detail-oriented Credit & Collections Specialist to join our team in Isando, Kempton Park. As a Credit & Collections Specialist, you will be...

  • Clinical Sales Specialist

    6 days ago

    Johannesburg, Gauteng, South Africa Boardroom Appointments Full time

    Clinical Sales Specialist **About the Role** We are seeking a highly motivated and experienced Clinical Sales Specialist to join our team at Boardroom Appointments. As a Clinical Sales Specialist, you will be responsible for driving sales growth and expanding our presence in the cardiovascular and electrophysiology markets. **Key Responsibilities** *...

  • Business Growth Specialist

    1 week ago

    Johannesburg, Gauteng, South Africa Persona Staff Full time

    Business Development Opportunities At Persona Staff, we're seeking a highly skilled Business Development professional to join our team. As a Business Growth Specialist, you will be responsible for identifying and pursuing new business opportunities, developing and implementing sales strategies, and building strong relationships with...

  • Procurement Specialist: IT

    7 days ago

    Johannesburg, Gauteng, South Africa Edge Executives Full time

    Edge Executives is seeking a seasoned Sourcing Specialist to join our team in the entertainment industry. The ideal candidate will have a strong background in supply chain and procurement, with a focus on technology and international markets. Key responsibilities include: * Sourcing and procurement of goods and services for large-scale projects * Developing...

  • Product Specialist

    6 days ago

    Johannesburg, Gauteng, South Africa Clinigen Full time

    Job DescriptionJob Title: Product SpecialistCompany: ClinigenJob Type: Full-timeLocation: Remote (with occasional travel)About Us: Clinigen is a leading global specialty pharmaceutical company that provides innovative solutions to patients and healthcare professionals.Job Summary: We are seeking a highly motivated and experienced Product Specialist to join...

  • Senior Transfer Pricing Specialist

    2 weeks ago

    Johannesburg, Gauteng, South Africa Network Recruitment Full time

    **Job Title:** Senior Transfer Pricing Consultant**Company:** Network Recruitment**Job Description:**We are seeking a highly skilled Transfer Pricing specialist to join our team at Network Recruitment. As a Transfer Pricing specialist, you will have the opportunity to work with a household brand and specialize in Transfer pricing.This role provides the...

Provider Relationship Specialist

3 months ago

Johannesburg, Gauteng, South Africa Kaelo Full time
Company Description

Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change.

Kaelo meets the Healthcare needs of Corporate and Retail clients across South Africa - products offerings include Medical Insurance, Medical Aid, Gap Insurance, Kaelo Money and employee assistance programmes.


Job Description:

The Provider Relationship Specialist is responsible for the day to day management of the multi-disciplinary network. Ensuring that contractual obligations with medical schemes, insurance and primary care products are established and maintained.

Maintaining strong relationships with DSP's via periodic engagement and implementation of standards and to manage and maintain quality assurance checks.

Query resolution and effective interaction management. Manage contracts and service level agreements, through effective reporting and administration.

KEY OUTCOMES (not limited to) Level 4 and 5 process elements

Management of Multi-disciplinary Network:


Establish and maintain a Provider Network to serve patients in accordance with contractual obligations with medical schemes, insurance and primary care products.

Ensure all required documentation is obtained from the provider prior to activating the contract

Train providers in keeping with Prime Cure services, policies and procedures

Develop and implement sound administrative, communication and operational systems to ensure consistent service delivery

Set work standards and ensure that these standards are met

Implement quality assurance procedures within the provider network

Resolve queries between funders, Prime Cure and service providers.

Ensure all interactions with providers are documented and SOP's are followed

Traveling may be required to visit for elite and contravening practices

Service level agreement management:

Ensure that each service level agreement is adhered to and met by the relevant business unit owner

Monitor trends within the business that may adversely affect the SLA and ensure the line manager and relevant business unit owners are kept informed

Ensure all queries are dealt within contracted SLA all stakeholder are kept informed of relevant progress work items or escalations

Ensure all provider details are kept up to date on MIP and provider lists

Reporting:

Compile daily, monthly, quarterly and ad hoc reports with precision and quality and submit these internally and externally at the agreed deadline dates for providers allocated to you

Collect data timeously for the compilation and completion of reports to Divisional Head Network and Risk executive

Complete quality audits monthly on all network related SOP's

Provide reporting on engagement with providers

Use of data to effectively identify and engage non-performing sites

Qualifications:

SPECIAL REQUIREMENTS
Ability to maintain confidentiality, problem solve, negotiate and communicate

Ability to work in fast paced, High pressure environment

Valid SA Driving licence



PERSON DETAILS:
WORK EXPERIENCE

REQUIRED
At least 3 years' experience in the Medical Scheme or Healthcare Administration industry in a client support or provider Management roll

PREFERRED
Proven work experience as a client or provider Management role



EDUCATION:

QUALIFICATIONS:
ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED
Grade 12 or equivalent NQF 4 certificate

PREFERRED

TECHNICAL SKILLS OR KNOWLEDGE

REQUIRED
Computer Literacy - Microsoft Excel, Word and PowerPoint

PREFERRED
Strong Knowledge of Medical Scheme Industry (Optom, Pharmacy, Dental, GP, Hospital)

Additional Information
- **Accountability**:

  • Action orientated:
-
Collaborative:

-
Communication:

-
Business writing skills:

-
Manage complexity:

-
Problem solving skills:

-
Decision thinking:

-
Encourages engagement:

-
Resilient and adaptive**:

-
Resourceful:

-
Demonstrates self-awareness:

-
Purpose driven:

- ** Significance and values orientated