Job Summary
Cimas wishes to invite applications from suitably qualified and experienced individuals to fill the position of Provider Liaison Administrator that has arisen within our organization.
Duties And Responsibilities
Profiles the Service Providers for enrolment onto the service provider network using analysed data and knowledge of Providers
Plans and organises engagement meetings with Service Providers to build relationships with them
Creates Cimas outposts with existing doctors and robust referral system within the Blue Zone network
Determines financial incentives and utilizes data and feedback to identify opportunities to improve the relationship between Cimas and Service Providers
Gathers medical industry information, interprets, and shares with internal contact for the benefit of the organization
Refers to the Provider Liaison Coordinator, Head Managed Care and Forensic Department identified cases of suspected fraud, waste, abuse and follows up the cases to finality
Supervises calculation and compilation of tariff schedules in line with medical aid tariff reviews and forwards to the Head Managed Care for quality control
Conducts research on alternative reimbursement models for medical aid cost containment and recommends to the Head Managed Care
Participates in Cimas weekly tariff committee meetings where discussions on innovative ways of handling tariffs to provide value are discussed
Monitors registration of service providers onto the Cimas System
Designs and reviews training materials for provider training workshops
Reviews provider claims to ensure compliance to claiming procedures
Arranges the accreditation of new institutions in line with Cimas standard operating procedures
Qualifications And Experience
Candidate Requirements
Diploma/Degree in General Nursing or any relevant Health Degree
Desirably a Post- Graduate qualification in Health Sciences
Valid Practicing Certificate as a Registered Health Practitioner
Experience in Healthcare Digital Systems Administration, Claims Handling and Knowledge of Healthcare Finance
Ability to manage and develop staff
Clear verbal and written communication and ability to prepare accurate reports
Ability to plan and organise in line with job requirements
Ability to interact, negotiate and achieve targets
Job Summary
More Information
- Job Application Details https://www.cimas.co.zw/careers/job/provider-liaison-administrator