Care Analyst, Provider Relations at Liberty Life

Job Description

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

Job Summary

The role is responsible for Servicing providers management, contracting, accreditation, and audits

Key Responsibilities

Maintain a cordial working relationship with providers within Heritage 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 rates and customary fees. Coordinate provider audit to ensure quality services is accessed by Heritage 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 service access procedure/processes, update on any changes at Heritage 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 provider panel and timely sharing with relevant stakeholders.

Requirements

Qualifications

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

Experience

3 years’ experience in medical insurance/hospital or related industry

Competencies

Understanding of health insurance operations and concepts Knowledge of medical claims processes and procedures Provider and stakeholder management Analytical skills, Customer service Delivering results and meeting customer expectations Coping with pressures and setbacks Analysing Working with people Adapting and responding to change Planning and organizing Presenting and communicating information Learning and researching Adhering to principles and values Achieving personal work goals and objectives