Care Analyst, Provider Relations at Liberty Life

Liberty Life Assurance Kenya is a life insurance provider that has been providing relevant products to Kenyans for over 50 years. Our purpose at Liberty is to make a difference in people’s lives by making financial freedom possible. We change realities and make freedom possible by providing innovative and relevant solutions that help our customers prote...
Care Analyst, Provider Relations


Job Summary

The role holder will be responsible for service providers management, contracting, accreditation and audits

Key Responsibilities

Maintain a cordial working relationship with providers within the Heritage Insurance provider network
Accredit new service providers to meet the client’s needs/demands
Negotiate service fees upon contracting of new service providers, guided by the Heritage Insurance rates and customary fees
Coordinate provider audits to ensure quality services are accessed by Heritage Insurance clients
Enforce compliance to Heritage rules and procedures regarding member access, policy exclusions and panel rates
Coordinate with Underwriting/Actuarial & prepare monthly utilization report on performance of service providers and develop appropriate measures to contain cost
Proper documentation of all service provider contracts and ensure timely renewal and KYC updates as per the set guidelines
Train Service providers on Heritage Insurance service access procedure/processes, update on any changes at Heritage Insurance in term of health products, existing processes and other related claim policies
Engage service providers in negotiation for discounts and close finance reconciliations
Liaise internally with other sections to ensure resolution of service provider related issues
Regular update of the Heritage Insurance provider panel and timely sharing with relevant stakeholders

Qualifications

Bachelor’s degree/Diploma in Nursing, Clinical Medicine, Pharmacy, or medical - related discipline

Experience

At least 3 years’ experience in provider relations in medical insurance, hospital or related industry

Competencies

Excellent communication and negotiation skills
Good analytical skills
Computer literate in MS Office and excel applications
Good knowledge of provider dynamics and landscape
Cost Optimization strategies