Medical Service Provider Networks Business

2 weeks ago

Cape Town, South Africa BQuad Solutions Full time

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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