Wednesday, 24 February 2021

Provider Relation Officer – Medical at CIC Group

CIC Insurance Group Limited, commonly referred to as CIC Group, is an insurance and investment group that operates mainly in Kenya, Uganda, South Sudan and MalawiPURPOSE:

The jobholder shall be responsible for management of service provider in relation to contracting, accreditation and rationalization of existing service providers.

Primary Responsibilities:

  • Maintain a cordial working relationship with providers within CIC provider network.
  • Perform provider audit to ensure quality services is accessed by CIC clients and enforce compliance to CIC rules and procedures regarding member access and policy exclusions.
  • Accredit new service providers to meet the client’s needs/demands.
  • Prepare monthly utilization report on performance of service providers and develop appropriate measures to contain cost.
  • Negotiate service fees upon contracting of new service providers, guided by the CIC rates and standard customary fees.
  • Proper documentation of all service provider contracts and ensure timely renewal as per the set guidelines.
  • Train Service providers on CIC service access procedure/processes, update on any changes at CIC in term of health products, existing processes, new schemes on board, terminated schemes and other related claim policies.
  • Engage service providers in negotiation for discounts and follow up to ensure it’s earned.
  • Liaise internally with other sections to ensure resolution of service provider related issues.
  • Regular update of the CIC provider panel and timely sharing with relevant stakeholders.

Person Specifications

Academic Qualifications

  • Bachelor’s degree in Nursing(KRCHN), Health Management or in a related field
  • Computer Literate

Experience

  • Up to two (2) years relevant experience in provider relations section

Skills and Attributes

  • Excellent communication and presentation skills
  • Problem solving skills
  • Good analytical skills
  • Excellent interpersonal skills
  • Excellent customer care skills
  • Computer literate in MS Office and other office applications

If you have the aforementioned professional and academic qualifications and you are ready to execute the above mandate.

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