PROVIDER NETWORKS SPECIALIST

Kenya, Africa

About the Company

A well-established Insurance Company is looking for an experienced Provider Networks Specialist to join their team in Kenya.

About the Role

This role will be responsible for developing and executing negotiation strategies working directly with contracted providers such as clinics, outpatient facilities, pharmacies, among others, in order to deliver best in class service to the company’s panel of providers, customers and clients and act as the Subject Matter Expert regarding the local market’s environment, healthcare delivery practices and pricing for the Africa region.

  • Manages the contracting and relations with medical facilities, including but not limited to: Hospitals, clinics, pharmacies, and physicians.
  • Analyses and determines in which countries, regions, and cities the network of providers must grow.
  • Works with Network Leads in performing service area analysis and cost analysis to identify network development and network renegotiation opportunities.
  • Negotiate with clients and client managers the most appropriate network extension efforts in the allocated region.
  • Negotiates and discuss agreements (direct payment agreements and/or discounts fees and price agreements).
  • Visits clients and manages the relationship with the providers under agreement in allocated regions and monitor the quality of their services and execution of the agreements in conjunction with a more Senior Provider Negotiator or Network Lead.
  • Acts as an expert with regards to the medical landscape in the countries within your region and continuously monitor evolutions in that respect
  • Ensures the correct handling of all administrative aspects of the agreements with the providers,
  • Maintains the Provider Data Base (PIMS) and make overviews of provider networks for all providers within the assigned region.
  • Analyses price lists and data, write clear conclusions and identify cost containment opportunities.
  • Act as the internal key person for all other Units and departments for issues relating to the providers in the allocated regions. Especially intensive communication with Clinical, Service OPS and Sales and Client Management.
  • Act as representative in the Outpatient Direct Payment project (OPDP)
  • Effectively communicates and interacts with other business units to achieve goals, e.g. Medical Management, Service Operations (NA, UK and Antwerp), Sales and Client Management (NA, UK, and Antwerp), and Strategy & Operations.

About the Individual

  • Ability to travel to and spend a lot of time in the countries in West Africa (post COVID) – ideally would have knowledge of this location
  • Strong relationship management & negotiation experience within Healthcare Insurance/Health Services.
  • Be on the ground with providers in West Africa – build relationships, trust and sell the company’s brand.
  • Fluent in written and spoken English, French is a must.
  • University degree or equivalent experience
  • Minimum 5 years of relevant experience with atleast 3 years in network/provider relations experience.
  • Working knowledge of the Provider Network is required.
  • Good communication and negotiation skills.
  • Analytical and critical mind.
  • Proficiency with MS Office programs including: Word, PowerPoint, Excel, Project, and Visio required.

Salary

Salary commensurate based on Candidates’ experience

Benefits

An excellent bonus scheme and other benefits

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Karan Seernani

Recruitment Associate

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