Regional Relationship Manager, North Eastern

Purpose for the Job

To head the regional unit composed of several counties clustered together, linking Minet and all members covered under the Managed Medical Care medical schemes, ensuring that Service Providers in the region provide adequate service, to the satisfaction of both the member and the client.

Duties and Responsiblities

Managerial Roles and Responsibilities:

• Leadership and management support to the regional staff.
• Effective management of county scheme operations.
• Build strong working relationships with key regional stakeholders.
• Develop strong partnerships with medical service providers in the region.

Operational Roles and Responsibilities:

• Manage the regional office administration function through the administrative assistant.
• Coach, train and mentor regional staff on scheme operations, case management and customer service.
• Ensure case management compliance via care managers.
• Case management for high-cost service providers in the region with an aim of managing costs.
• Resolve issues escalated by the care managers, training coordinators and customer service representatives in their counties.
• Proactively identify cost saving measures as well as analyze high-cost claims in conformance with the authorization and verify and identify possible overcharging, unnecessary expenditure and errors and to rectify such occurrences.
• Communicate relevant information to the member, including but not limited to scheme rules, benefit structure and alternative treatment options.
• Prepare monthly management reports on activities within the region; customer service, service provider relations, case management, training, communication, personnel issues, positive highlights and challenges faced.

Any other duty as may be assigned by the supervisor

Key Result Areas

• Customer Service
• Policy guidance
• Care options information
• Discount negotiations/Cost Control
• The ability to motivate and inspire the team to action
• Medical guideline orientation

Key Competencies

• Stakeholder Management
• Case management
• Benefit coordination
• Conflict resolution

Knowledge And Skills Required

• Communication skills
• Detail oriented
• Interpersonal skills
• Negotiations skills
• Leadership skills

Professional and Academic Qualifications

• Degree preferably in a Health-related course e.g. Health Systems Management
• Certificate of proficiency (COP) in Insurance