Provider Relations Officer – Medical At Cic Insurance

PURPOSE:Responsible for management of service provider in relation to contracting, accreditation and rationalization of existing service providers.PRIMARY RESPONSIBILITIES:Maintain a cordial working relationship with providers within CIC provider network.Perform provider audit to ensure quality services is accessed by CIC clients and enforce compliance to CIC rules and procedures regarding member access and policy exclusions.Accredit new service providers to meet the client's needs/demands.Prepare monthly utilization report on performance of service providers and develop appropriate measures to contain cost.Negotiate service fees upon contracting of new service providers, guided by the CIC rates and standard customary fees.Proper documentation of all service provider contracts and ensure timely renewal as per the set guidelines.Train Service providers on CIC service access procedure/processes, update on any changes at CIC in term of health products, existing processes, new schemes on board, terminated schemes and other related claim policies.Engage service providers in negotiation for discounts and follow up to ensure it's earned.Liaise internally with other sections to ensure resolution of service provider related issues.Regular update of the CIC provider panel and timely sharing with relevant stakeholders.Academic and Professional RequirementsEducationBachelor's degree in Nursing(KRCHN), Health Management or in a related field EComputer literate in MS Office and other office applications EExperience Required:2 years Relevant experience in Provider Relations Section