Role Purpose

• To maintain client portfolio’s through relationships and business retention.

Requirements

• Tertiary qualification in clinical/medical  field an advantage.
• 4 year experience in the Medical Scheme Administration industry.
• Code 8 drivers licence and own vehicle.
• Experience interacting at a senior level with / in companies an advantage

Duties & Responsibilities

• Front-line external consultation with service providers.
• Responsible for problem solving at all levels.
• Written and verbal communication at a professional level with individual service providers.
• One-on-one problem solving sessions on-site.
• Build and maintain good relationships with doctors.
• Queries and problems resolved accurately and timeously.
• The year-end process runs smoothly and is facilitated to ensure that doctors are fully aware of all changes and options available to them.
• Daily visits to service providers that are contracted to our scheme/s members.
• Ensure coverage and frequency targets attained on all providers.
• Draw and analyse practice profile statistics and other utilization reports.
• Conduct risk discussion with cost inefficient drs that have been identified to be risk managed.
• Consistently monitor cost effectiveness of all providers and have relevant discussions when & where necessary.
• Enable and reach a financial savings target per year.
• Train doctors and staff on scheme protocols and requirements.
• Drive compliance at provider level.
• Negotiate with and contract service providers onto provider networks.
• Maintain a good understating of areas in order to assist with contracting decisions.
• Bring feedback  from the field back to the business.
• Handle conflict situations at service provider level independently.
• Plan work visit schedule and execute independently.
• Escalate client queries to the relevant department or stakeholder.
• Provide accurate information and advice to doctors and stakeholders.
• Provide regular reports and keep accurate notes about interactions with providers according to overall department targets.
• Provide authoritative, expertise and advice to doctors and stakeholders.
• Build and maintain relationships with doctors (external) stakeholders.
• Make recommendations to improve client service and fair treatment of clients within area of responsibility.
• Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service.
• Constantly strive to improve service delivery to contracted providers.
• Develop and maintain productive and collaborative working relationships with peers and stakeholders.
• Positively influence and participate in change initiatives.
• Represent MMI and act as ambassadors for the company in all/daily  external interactions.
• Continuously develop own expertise in terms of professional and industry knowledge.
• Contribute to continuous innovation through the development, sharing and implementation of new ideas.
• Identify opportunities to enhance cost effectiveness and increase operational efficiency.
• Manage financial and other company resources under your control with due respect.

Competencies

• Business Acumen.
• Client/ Stakeholder Commitment.
• Drive for Results.
• Collaboration.
• Impact and Influence.
• Self-Awareness and Insight