Description |
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Main Tasks
Network Management
Creation of an appropriate panel of medical providers within the company's area of operation (Middle East).
Management of medical service providers, including negotiation and implementation of standard contractual terms and conditions, up to signing of agreements. The emphasis will be upon delivering competitive volume pricing, procedure pricing, package pricing, fixed discounts expressed as a percentage of the final bill etc.
Provision of appropriate training, documentation and support to panel members.
Recording and maintenance of all medical provider details in the region onto the Provider database. Such entries to include the following:
Completion of appropriate financial arrangements with providers including, the management of claims costs.
Provide on demand information on medical service providers to internal departments as required, and having this information updated and available through the provider database.
Contribute towards the development of a system for measuring service providers performance, both in terms of quality of service as well as in cost efficiency.
Superior Service Delivery
Commitment and delivery of the Companys service standards, including a 24 hours turnaround for all claims and other written communication and a target call abandon rate of 2%.
Promote high Customer Service and Quality ethos on the team and in the company as appropriate.
Help Line
The management of an in-house 24/7 helpline, providing phone, fax and email service to insured members in Arabic, English and French.
Claims
Management of full claims adjudication, processing and payment function communicating with clients, distributors and providers as required.
People Management
Including all HR related issues, as well as performance management and development.
Work monitoring, coaching and feedback
Behaviour/Values
Customer Focused
Strong communication (verbal & written) and interpersonal skills
Strong negotiation skills
Ability to work effectively within a team environment
Honesty & integrity
Ability to work well under pressure
Ability to work on own initiative
Highly motivated & proactive
Results driven & solution oriented
Ability to prioritise workload and manage time effectively
Excellent leadership qualities & ability to delegate effectively
Ability to motivate others
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