✨ AI Summary
The Team Leader - Provider Relations is responsible for representing the company, empaneling new providers, and maintaining relationships with existing and new providers in Dubai. Reporting to the VP - Provider Relations, this role supports daily operations of the network team, ensuring goals are met, and leads specialized initiatives and projects. Key responsibilities include network expansion, managing existing providers, ensuring negotiations align with pricing targets and service standards, reviewing provider performance, preparing action plans, and project managing network expansion. The role also involves resolving complex provider disputes, operational gaps in onboarding/contracting, and managing projects for workflow automation. Maintaining expertise in digital platforms and system updates is crucial, along with completing special projects within TAT and supporting price and impact analysis.
Requirements
Requires a Bachelor's degree in a medical or business field with at least 7 years of relevant experience, including 5+ years in the Medical Insurance field. Skills in negotiation, provider relations, coding certification, digital platforms, medical background, provider management, and price analysis are essential.
Description
We are looking for a Team Leader in our Provider Relations department in Dubai. Team Leader - Provider Relations Officer is responsible for representing the company, empanelment of new providers and maintaining the relationship with the existing and new providers in the assigned region.Reporting directly to the VP - Provider Relations, this position supports in managing the daily operations of the network team and ensures the team meets its core operational goals. Additionally, this position leads specialized initiatives and executes various direct and cross-functional projects.Main ResponsibilitiesResponsible for NW expansion in the assigned region/ providersManagement of existing providers in the assigned region which includes service additions, provider visits, provider trainings, complaints resolution etcEnsure that all negotiations with the providers in the assigned region are in line with SAICO health benefits pricing targets, service quality standards and payment terms.Review and discuss provider performance and utilization.Prepare quarterly action plan for managing assigned providers.Project-manage to expand SAICOHEALTH network across all regions.Track Team Productivity in regards to NW provider management activities to ensure consistent department output.Serve as the first point of escalation for complex provider disputes, sensitive network issues, or internal system bottlenecks across all markets.Responsible to resolve any operational gaps in onboarding or contracting and manage projects dedicated to automating or streamlining these workflows.Maintains comprehensive expertise and continuous fluency in the latest digital platforms. Responsible to learn any newly implemented system software or system updates that affects PRD and responsible to impart trainings to the team.Responsible for the completion of any Special Projects assigned within the TAT. Scope, plan, and execute strategic projects from initiation to close-out phase.Responsible for supporting complex Price Analysis and Impact Analysis.Qualifications:Bachelor degree in medical or business field with an equivalent of 7+ years relevant experienceExperience5+ years of experience in the Medical Insurance fieldMedical background / coding certification is a plus