Our Client, a well established Managed Care company, is urgently recruiting for a Provider Liaison Officer. The Provider Liaison Officer will report directly to the Network Manager.
There is flexibility for the position to be based at their Head Office in Cape Town or alternatively within Gauteng or KZN regions. The total remuneration package for these positions is negotiable based on qualifications and experience.
The Provider Liaison Officer will be required to provide support to all clients within the network through the implementation of the following Key Performance Areas (KPAs)
Critical Skills/ Competencies
- Coordinate all activities including administration, planning, execution and time management of monthly targets
- Manage relationships with partners / vendors / Scheme and industry stakeholders via practice visits or digital interactions. Video Conferencing and remote communications are the only form of stakeholder engagement during the COVID-19 pandemic
- Accountable for adherence to company/scheme and legislative policies
- Maintaining accurate records of all provider interactions
- Accountable for achieving and reporting on required productivity targets, management/client reports and project deadlines
- Provide substantiated commentary on the quality of network services and provider compliance in support of the Scheme network agreements
- Serve as a point of contact for escalations related to claims, queries and complaints from clients
- Conduct surveys and recommend improvements to enhance the customer/prover liaison experience
- Adhering to and monitoring all Standard Operating Procedures (SOP’s) and work instructions
- Interfacing, negotiating and communicating with other Departments to ensure excellent and effective service delivery across the business and to the public
- Maintain contact with existing and potential customers/providers to promote the company, schemes and members
- Deliver against the growth strategy of the customer/provider base according to business targets
- Represent the Network department at SPN and Stakeholder Engagements
- Ensure that financial risk to the business, clients and providers are minimised
- Solutions driven
- Excellent Problem solving and Accuracy skills
- Good Telephone etiquette
- Business Acumen
- Self-starter, motivated, takes initiative and can work independently
- Excellent communicator with all levels in an organisation (verbal and written)
- Flexibility and agility
- Resilient mind-set
- Ability to operate in a team environment
- Prioritise deliverable and work load accordingly (good organisational skills)
- Must have valid driver’s license. Own reliable transport is essential for future travel
- Willing to travel Nationally in future
- Reliable internet connectivity is essential as main form of engagement will be via Video conferencing
- Candidates must have a clear criminal record
Education and Applicable Systems Experience
- 1-2 years’ experience within similar, Customer Service, Key account and/or Provider Relationship Management role
- Experience in the healthcare insurance/funding/medical scheme industry and knowledge of relevant legislative environment is highly desirable
- Experience in case/ claims management will be advantageous
- Sound Quantitative and qualitative analysis skills with ability to manage priorities
- Grade 12
- Relevant Tertiary Qualification (Diploma or Degree)
- Proficient in MS Office Suite applications with ability to scrutinise statistical data for the generation of reports
Should you wish to apply for the position, please apply directly via this job board, please ensure that you quote reference number 201862 subject heading or email body.
Please note that due to the high volume of CV's received; only shortlisted applicants will be contacted. Should you not receive communication from our offices within two weeks of submission please note that your application will not be considered for this position.
We will keep your CV on file and re-establish contact with you should opportunities in line with your expertise become available again.
Should you require any additional information give us a call on 021 012 5566.