Corporate Care Associate (Provider Relations) at Britam

Job Purpose and Key responsibilities

Reporting to the Team Leader Corporate Care, the role holder will provide guidance on all matters relating to cost management, provider on-boarding, provider relationship and provider audit process.

Key responsibilities

• Supervise relationship management with providers to ensure providers are satisfied with the company.
• Analysis of customer feedback surveys, provider complaints and compliments to inform decision making in provider experience. 
• Strategic cost control engagements with providers and monitoring adherence to service level agreements. 
• Price guided tariffs- building of provider pricelists especially for bigger providers on average pharmaceutical expenditure.
• Monitoring Average Costs of providers and engaging high-cost providers to reduce unnecessary expenditure.
• Supervision of provider audits to ensure that quality, cost effective medical services.
• Supervision of the contracting process and ensure that all providers have active and updated contracts.
• Ensure compliance with to any regulatory or health sector changes, such as billing and payment requirements.
• Any other duties assigned by the Team Leader Corporate Care division.

Key Performance Measures

• Saving the company money from wastage and exorbitant fees by providers.
• Medical fraud mitigation
• System support and integration on CPT coding

Knowledge, experience and qualifications required

• Diploma, Degree in Nursing or Diploma in clinical Medicine or Diploma in Pharmacy
• Moderate understanding of Insurance concepts
• Professional qualification in FLMI,ACII and IIK
• 3-5 years’ experience in provider management

  Emerging Leaders in Britam need to:

• Plan, direct and apply efficiencies and resources in order to optimise output and profitability against time, cost and team targets;
• Effectively communicate strategic and operational departmental goals and objectives to peers and others in order to ensure proper implementation;
• Ensure that department priorities are adhered to and effectively communicated;
• Ensure competent and effective people resources through appropriate coaching, development and people supervision as appropriate;
• Embody a high performance, proactive culture;
• Effectively ensure the adherence to key performance areas, deadlines and goals in order to optimise operational effectiveness;
• Effectively communicate resource needs, possible opportunities and achievements to management in order to aid them in their decision-making;
• Effectively set and monitor priorities and objectives for more junior staff;
• Understand and communicate objectives in relation to the larger organisational impact;
• Effectively disseminate knowledge within the correct context, towards subordinates as well as management;
• Appropriately model the company values while setting the pace and energy for delivering;
• Effectively manage and communicate change within the department in order to increase staff and process effectiveness;
• Provide access to accurate and consistent information and services across all channels;
• Ensure a seamless experience for clients;
• Improve service delivery for clients;
• Engage in continuous brand building to become the trusted partners to clients.

Emerging Leaders Competency Descriptions.

• Presenting and Communicating Information - Speaks fluently; expresses opinions, information and key points of an argument clearly; presents effectively; responds quickly to others ‘reactions and feedback during conversations; projects credibility.
• Working with People - Shows respect for the views and contributions of team members; shows empathy; listens, supports and cares for others; consults others and pro-acitvely shares information and expertise with them; builds team spirit and reconciles conflict; adapts to the team and fits in well.
• Adhering to Principles and Values - Upholds and encourages ethical behavior and departmental values; demonstrates integrity; encourages individual responsibility towards the community and the environment; models the organizational values during every day interactions.
• Analyzing - Analyses numerical data and all other sources of information, breaking them into component parts, patterns and relationships; probes for further information or greater understanding of a problem; makes rational judgments from the available information and analysis; demonstrates an understanding of how one issue may be part of a much larger system / process / problem.
• Planning and Organizing - Adheres to and monitors clearly defined objectives; plans activities and projects well in advance and takes account of possible changing circumstances; identifies and organizes resources needed to accomplish tasks; manages time effectively; monitors performance against deadlines and milestones.
• Delivering Results and Meeting Customer Expectations - Focuses on customer needs and satisfaction; sets and models high standards for quality and quantity; monitors and maintains quality and productivity; works in a systematic methodical and orderly way; consistently achieves projects goals.
• Deciding and Initiating Action - Takes responsibility for own, as well as subordinates’ actions and projects; takes initiative and works under own direction; initiates and generates activity; introduces improvements into work processes; handles problems with minimal guidance.
• Leading and Supervising - Provides subordinates with a clear direction; motivates and empowers others; provides subordinates with the relevant coaching; creates a positive climate that fosters learning and development; identifies high potential talent; sets and articulates the departmental vision and values through own personal behavior; sets appropriate standards of behavior.
• Formulating Strategies and Concepts - Works strategically to realize personal goals; understands and effectively communicates the departmental strategy; translates the departmental strategy and vision into operational responsibilities; takes into consideration departmental strategy during all tasks; takes account of a wide range of issues across, and related to current role.
• Applying Expertise and Technology - Applies specialist and detailed technical expertise; uses technology to achieve work objectives; develops job knowledge and expertise (theoretical and practical) through continual professional development; demonstrates an understanding of different organizational departments and functions.
• Following Instructions and Procedures - Challenges authority only when appropriate; follows procedures and policies; keeps to schedules; arrives punctually for work and meetings; demonstrates a commitment to the organization; complies with legal obligations and safety requirements of the role.
• Adapting and Responding to change - Adapts to changing circumstances; tolerates ambiguity; accepts new ideas and change initiatives; adapts interpersonal style to suit different people or situations; shows an interest in new experiences.