Team Leader- Provider Relations
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Key skills for this role
About the Role
We are looking for a Team Leader in our Provider Relations department in Dubai. Team Leader - Provider Relations Officer is responsible for representing the company, empanelment of new providers and maintaining the relationship with the existing and new providers in the assigned region.
Key Skills for This Role
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Overview
We are looking for a Team Leader in our Provider Relations department in Dubai.
Team Leader - Provider Relations Officer is responsible for representing the company, empanelment of new providers and maintaining the relationship with the existing and new providers in the assigned region.
Reporting directly to the VP - Provider Relations, this position supports in managing the daily operations of the network team and ensures the team meets its core operational goals.
Additionally, this position leads specialized initiatives and executes various direct and cross-functional projects.
Main Responsibilities
1.
Responsible for NW expansion in the assigned region/ providers
2.
Management of existing providers in the assigned region which includes service additions, provider visits, provider trainings, complaints resolution etc
3.
Ensure that all negotiations with the providers in the assigned region are in line with SAICO health benefits pricing targets, service quality standards and payment terms.
4.
Review and discuss provider performance and utilization.
5.
Prepare quarterly action plan for managing assigned providers.
6.
Project-manage to expand SAICOHEALTH network across all regions.
7.
Track Team Productivity in regards to NW provider management activities to ensure consistent department output.
8.
Serve as the first point of escalation for complex provider disputes, sensitive network issues, or internal system bottlenecks across all markets.
9.
Responsible to resolve any operational gaps in onboarding or contracting and manage projects dedicated to automating or streamlining these workflows.
10.
Maintains comprehensive expertise and continuous fluency in the latest digital platforms.
Responsible to learn any newly implemented system software or system updates that affects PRD and responsible to impart trainings to the team.
11.
Responsible for the completion of any Special Projects assigned within the TAT.
Scope, plan, and execute strategic projects from initiation to close-out phase.
12.
Responsible for supporting complex Price Analysis and Impact Analysis.
Qualifications
- Bachelor degree in medical or business field with an equivalent of 7+ years relevant experience
Experience
- 5+ years of experience in the Medical Insurance field
- Medical background / coding certification is a plus
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