Provider Liaison Officer

2 months ago

East London, South Africa Tych Business Solutions Full time

The **Provider Liaison Officer **will be required to provide support to the Manager: Provider Liaison Office through the implementation of the following **Key Performance Areas (KPAs)**:

- Support the Manager: Provider Liaison Office in maintaining the client relationship with healthcare providers within the assigned region
- Participate in the review and submission of client networks reports
- Support the Manager: Provider Liaison Office in the management of the Managed Care Organisations that are contracted by the Scheme
- Participate in the review of the providers efficiency reports
- Provide substantiated commentary on the quality of network services and provider compliance to the Scheme network agreements
- Represent the Healthcare Management Division at SPN and Stakeholder Engagements and promote network participation by healthcare providers
- Provide substantiated commentary on the quality of network services and provider compliance with Scheme network agreements
- Provide periodic reports relating all stakeholder engagements to the Senior Manager: Networks and Provider Relations
- Ensure continuous education on client strategy, systems, processes, and product to the providers within the assigned region
- Serve as a single point of contact for escalations related to claims and authorizations issues from the providers within the assigned region.
- Perform a secretariat function for the provider relations engagements
- Support other Scheme Division’s in managed care activities
- Fulfil various stakeholder engagements as directed by the Chief Healthcare Officer

**Qualifications and other requirements are**:

- At least a 3-year Diploma/Degree or equivalent NQF level 6 in Clinical Sciences related fields
- At least 5 years of work experience in the healthcare funding/medical scheme industry
- Must have experience in provider relations management
- Experience in case/ claims management will be advantageous
- Must have experience in the development and presentation of management reports
- Computer literacy and MS Office skills
- Sound Quantitative and qualitative analysis skills with ability to manage priorities
- Have ability to work well as part of a team
- Be responsible and reliable
- Have diligent work ethics with attention to detail
- Excellent communication and writing skills
- Have sound planning/project management skills
- Be a self-starter
- Own transport essential

**Job Type**: Permanent

**Experience**:

- healthcare funding/medical scheme: 5 years (preferred)

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