Total Health Trust Limited Vacancy for a Provider Management Executive
Total Health Trust Limited - Our organization is a
leading and largest health maintenance organization (“HMO”) in Nigeria
with over 270,000 members and over 270 private corporations
representing
some of the country’s top local and international multinationals, as
well as public sector institutions under our management. We were the
first HMO to be registered in Nigeria and 17 years later, we are still
number one in the market. We are one of the very few HMOs that can boast
the financial and technical backing of a world class company – Liberty
Health (a member of the Liberty Group). The organization further prides
itself with its rich culture of Respect, Compassion, Pride and
Expertise.
Job Title: Provider Management Executive
Job Description:
- To conduct hospital visit,
inspection, accreditation, re-accreditation, education, claims audit,
fraud detection, clinical audit, investigation of member’s related
queries, resolve issues of short-payments as the need arise
- Update providers register under schemes and share updates with concerned departments
- Provide detailed provider management report
- Ensure that all critical areas
that require improvement that contribute to the success of the strategy
are identified and communicated to the team lead.
- Ensure prompt registration and processing of providers’ contracts on Medware.
- Implement provider management strategies for organizational growth, competitiveness and leadership
- To reconcile provider account received from the geographical regions assigned as well as any other delegated by the team lead.
- Organize and carry-out product, policies and processes training in-house for group of providers in assigned geographical areas.
- To negotiate with doctors and other health care providers about health care for clients
- Liaison with NHIS
- Represent organization in the health care events
Requirements:
- Candidate must be a registered nurse, midwife and possess B.Sc. Nursing
- Additional medical qualification will be an added advantage
- Candidate must have advanced
knowledge of NHIS regulatory guidelines, Medical Global Best Practices,
Health Insurance, Products and Processes.
- Excellent organizational, communication (verbal and written) skills and attention to detail
- Candidate must have minimum of
5 years post-nursing qualification experience including 3 years in
similar role in a Health Maintenance Organization (HMO).
- Candidate must have Clinical experience
Other requirements:
- Good organizational and planning capabilities
- Innovative and quick thinking capabilities
- Negotiation Skill
- Adaptive, expertise, Result-Oriented, Relationship Skill
- Working with people
- Strategic
- Must be a good collaborator/Team player
- Innovativeness
- Adaptive
- Decision Making skills
- Integrity
How to Apply
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