Medical Service Provider Networks Business
7 months ago
Business Development Consultant required to develop integrated medical service provider networks within the Western Cape region for a rapidly growing primary healthcare insurance provider.
Duties & Responsibilities
Development of integrated medical service provider networks within the region identifying any access gaps
Building relationships with various medical service providers through regular visits over an extensive area
Meeting targets and regulatory requirements
Development of action plans to support provider practices to ensure high quality services to members
Provider education and evaluation of practices to ensure compliance to high levels of member care
Contract compliance and resolving provider concerns/issues
Negotiate contracts on an individual or group basis for provider network, casualty and hospital contracts
Ensure a seamless provider experience within the organisation
Handle all customer queries
Take action regarding excessive costs charged by providers and continually assess and manage risk
Monthly management reports
Experience and Qualification
Matric and Commercial Diploma a minimum
RE 5 and Class of Business
Minimum 2 years experience in a similar role*\
Health industry, insurance options and benefits knowledge
Proven track record of meeting targets
Understanding of medical providers claims administration systems and business operations in order to solve issues
Claims risk profiling
MS Office (Word and Excel) a MUST
Extensive provincial travelling to all medical service providers within the network (on the road role not office based, though home office set up advantageous)
Salary
R30 000.00 to R35 000 CTC (including Medical Insurance and Provident Fund)
**Salary**: R30,000.00 - R35,000.00 per month
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