Service Provider Relations Officer

Education

• Bachelors Degree (B): Medicine (Required), Bachelors Degree (B): Nursing (Required), Bachelors Degree (B): Public Health (Required)
  

• Manage provider contracting frameworks, including negotiated tariffs and reimbursement rates, annual tariff reviews, cost benchmarking against market rates, and the administration of capitation and fee-for-service (FFS) models.
  
• Build and sustain strong, strategic relationships with medical service providers through structured and ongoing engagements to enhance customer loyalty, service quality, and network performance.
  
• Design, implement, and continuously improve a quality assurance framework to ensure high standards of healthcare service delivery to Old Mutual clients.
  
• Gather, analyze, and interpret market intelligence on provider practices to inform pricing strategies, quality improvement initiatives, and operational decision-making.
  
• Negotiate, reconcile, and manage provider tariffs, including the development of medical and surgical packages to secure competitive and cost-effective pricing.
  
• Implement and manage a provider tiering framework to support cost control, member alignment, and consistent provider categorization across the business.
  
• Develop and execute a provider network expansion strategy, including the establishment of telemedicine and digital health partnerships to strengthen chronic disease management.
  
• Ensure timely follow-up on provider payments and remittances in line with agreed service level agreements (SLAs).
  
• Coordinate and deliver training programmes for service providers on Old Mutual’s service standards, claims guidelines, policies, and operational processes.
  
• Share provider remittance statements and payment advice accurately and within agreed timelines and resolve related provider queries promptly.
  
• Monitor and address customer service issues to ensure timely resolution and an enhanced customer experience.