Medical Network Officer

  • Full Time
  • Lusaka

MedNet

Job title: Medical Network Officer

Company: MedNet

MEDICAL NETWORK OFFICER – PROVIDER RELATIONS

Med Net is one of the leading managed care service organizations that caters to healthcare needs and offers financial protection against unforeseen health crisis and expenses across the GCC region. We are currently seeking to hire a suitable candidate for the position of: Medical Network Officer – Provider Relations

The Role:

This role is related to maintaining relationships with hospitals / clinics / pharmacies. The role will be to assist the Assistant Manager – Provider Relations and Contracting in the development of the healthcare service provider network.

Your Job:

Identify sub-categories of providers and preferred providers through provider profiling analysis, to create distinctive network advantages for MedNet

Negotiate contracting and re-contracting processes with healthcare service providers within corporate guidelines to ensure all services provided are cost-effective and in accordance with quality standards

Conduct presentations and trainings for appointed healthcare provider staff on managed care concepts and provide updates on all related procedures in order to ensure awareness of MedNet service requirements and policies across the network

Review the policy manual and network agreements in an ongoing basis and provide suitable recommendations

Support the Team Leader / Manager in the implementation of quality assurance programs in order to maintain the standards of quality and minimize fraudulent cases

Develop and maintain monthly statistical reports to facilitate the benchmarking and performance management of network operations for management decision making

Update MedNet with data relating to addresses, discounts, creation of new codes, specialties, etc. on a periodic basis

Prepare quarterly network newsletters intended for insured members, insurance companies and intermediaries Your Profile:

Diploma or Bachelors Degree in Medicine, Physiotherapy, Nursing, Radiology, Laboratory Technician or Hospital Administration

2-3 years of experience in a provider contracting role in the TPA / medical insurance sector preferably in the Gulf region

Good interpersonal skills and the ability to communicate clearly and effectively with internal and external clients across all levels, with fluency in business English and Hindi (written and spoken); Arabic would be an advantage

driving license is mandatory. The role involves travelling.

Industry knowledge related to local healthcare services system will be an added advantage Interested candidates may submit their resumes

Deadline: 28th/ 05/ 2024

Interested candidates should send their CVs

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