Job Purpose:

The role holder will be responsible for all matters relating to medical service providers to ensure very good relationship and satisfactory delivery of service to our clients. The role holder will visit all our admitted clients to collect feedback and assess service satisfaction.

Key responsibilities:

• Recruit service providers and maintain good relationship for smooth customer experience
• Make and sign off medical claims reconciliations with service providers to reduce company liability
• Make hospital visits for admitted patients to assess service satisfaction, patient prognosis and advise on interventions where necessary
• Negotiate medical services prices with service provider to get the best financial value for the company
• Coordinate and implement the system installation to all our service providers for member identification and claims posting
• Monitor, follow-up and resolve any system issue with the service providers to ensure maximum system uptime.
• Carry out training for service providers’ staff to ensure competence in using the system and understanding of the dos and don’ts as stipulated in the contract.
• Any other duty as may be assigned from time to time.

Key Performance Measures

• Expansion of service providers panel
• Loss ratio
• Customer retention rate
• Number of service providers with a functional system
• Number of system training and closed claims reconciliations
• Number of admitted clients visited

Working Relationships

Internal Relationships:

• Accountable to Manager, Medical Business
• Required to liaise and work closely with other departments as may be necessary

External Relationships:

• Britam customers
• Insurance sector players
• Medical service providers

Knowledge, experience and qualifications required:

• Diploma and above in health-related field.
• Computer skills, Ms Word, Excel & Power Point
• Experience in medical insurance and provider relations will be an added advantage.
• Knowledge of Tanzania insurance regulatory authority guidelines on medical claims and service providers management
• Knowledge of Britam medical insurance products

Technical/ Functional competencies

• Relationship management skills
• Excellent communication skills
• Strong negotiations skills
• Problem solving skills

• Recruit service providers and maintain good relationship for smooth customer experience
• Make and sign off medical claims reconciliations with service providers to reduce company liability
• Make hospital visits for admitted patients to assess service satisfaction, patient prognosis and advise on interventions where necessary
• Negotiate medical services prices with service provider to get the best financial value for the company
• Coordinate and implement the system installation to all our service providers for member identification and claims posting
• Monitor, follow-up and resolve any system issue with the service providers to ensure maximum system uptime.
• Carry out training for service providers’ staff to ensure competence in using the system and understanding of the dos and don’ts as stipulated in the contract.
• Any other duty as may be assigned from time to time.

• Relationship management skills
• Excellent communication skills
• Strong negotiations skills
• Problem solving skills
• Computer skills, Ms Word, Excel & Power Point

• Diploma and above in health-related field.
• Experience in medical insurance and provider relations will be an added advantage.
• Knowledge of Tanzania insurance regulatory authority guidelines on medical claims and service providers management
• Knowledge of Britam medical insurance products