Service Provider Relations Officer (9 Months Fixed Term Contract)

Job OverviewThe Service Provider Relations Officer is tasked with building and maintaining strong partnerships with healthcare service providers. The role ensures quality service delivery, cost management, adherence to contracts, and improved member satisfaction. Additionally, the officer supports fraud detection, monitors provider compliance, and helps contain costs within the healthcare provider network.Key ResponsibilitiesIdentify, assess, and onboard healthcare providers following company standards.Negotiate contracts, tariffs, and service level agreements with providers.Maintain an up-to-date provider database including licensing and compliance records.Develop package pricing for common procedures to stabilize claims costs.Ensure sufficient geographic and specialty coverage in the provider network.Act as the main contact between the company and healthcare providers.Conduct regular visits, audits, and performance evaluations of providers.Address provider disputes, complaints, and operational issues.Monitor billing patterns to detect fraud, waste, and abuse.Investigate irregular billing and recommend corrective measures.Ensure compliance with tariffs and contractual terms.Support cost containment through discount negotiations.Perform facility assessments and compliance audits.Track service quality indicators such as turnaround times and patient feedback.Prepare periodic reports on provider performance and utilization.Educate providers on policy updates, claims submission, and authorization procedures.Monitor onboarding turnaround times and dispute resolution efficiency.Evaluate frequency and effectiveness of provider audits and network adequacy.RequirementsDegree or Diploma in Health Systems Management, Nursing, Clinical Medicine, Public Health, Business Administration, or related field.Professional certification in insurance or healthcare management is an advantage.1–2 years’ experience in healthcare operations, medical insurance, or provider network management.

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