Provider Network Assistant

JOB DESCRIPTION

Position:             Provider Network Assistant

Department:     International Private Medical Insurance (IPMI)

Reporting to:     Network Provider Manager (directly) and Head of Health Operations (indirectly)

Location:           Johannesburg, South Africa

About Unisure:

The Unisure Group is an evolving international health and life insurance solutions provider that is leading the way when it comes to international individual and corporate health and life insurance solutions. We’re passionate about employee wellbeing, physical and mental health, as well as financial wellbeing, and we’re on a mission to improve work and home life for all of our policyholders. We do the same for our Unisure team members that dedicate their days to making the magic happen for our clients. We offer our employees career stability and exceptional growth opportunities that align with our company’s purpose of people, passion and partners.

Role Description:

The Provider Network Assistant’s (PNA) role is to assist and support the Network Provider Manager (NPM) with administrative and logistical duties, maintaining the current Unisure Assist medical provider network as well as the identification and establishment of new medical service provider networks in specific geographical areas.

Over and above the continuous maintenance of the existing provider network, the successful incumbent will also be responsible for the vetting of new providers to ensure that they prescribe to globally accepted best practices.

The PNA will be required to provide assistance and support to the International Private Medical Insurance (IPMI) and Medical Assistance departments (respectively) with clinical enquiries and coordinating the logistics of medical evacuations.

Job Responsibilities, Duties and Tasks:

The successful incumbent’s duties and responsibilities include, but are not limited to:

• Assisting the NPM with the updating and maintenance of the Unisure Assist existing contracted medical service provider network consisting of direct provider contracts, third-party assistance providers and aeromedical service providers.
• The maintenance of the existing medical service provider network includes, but it not limited to:
  • • Continuous checks to ascertain whether service providers are still operational and whether there were any changes in the scope of service provisioning.
    • Maintenance of the contact details of each provider and functional area which relates to billing, appointment scheduling, clinical services, and managerial escalation.
    • Tariff structure maintenance.
    • Continuous review of all licencing and insurance documentation relating to facility accreditation, malpractice, and general liability insurance.
    • General compliance checks on platforms such as Orbis and Bridger.
• Ensuring that all contracted medical service providers are clinically compliant with international best medical practice standards, whilst providing consistent, high-quality and cost-effective service and treatment provision.
• Identification of new medical service providers in new territories identified by the IPMI and Sales teams. The PNA will be required to establish contact with such facilities, identify the representing officer in the facility and hand the details over the NPM for contractual discussions and conclusion of said facilities.
• Assisting the NPM with additional administration requirements with regards to new systems, clinical protocols and guidelines where required.
• Assisting the IPMI teams with any clinical claims queries on an ad hoc basis.
• Providing support to the Medical Assistance department with clinical calls, escalations and the coordination of the logistical areas relating to medical evacuations.

Job Skills & Qualifications:

• Formal clinical qualifications (Advanced Life Support Paramedic / Registered Nurse)
• Experience in medical assistance service provision. An Emergency Medical Service background would be beneficial
• Knowledge of the African market (logistics and operations) with exposure to international markets which includes but is not limited to dealing with international medical service providers, aeromedical evacuations, hospitals and emergency services and clinical auditing
• Experience in relation to medical service provider engagements and negotiations
• Professional and confident self-starter that avails advanced communication and negotiation skills
• Microsoft Office software literacy
• Valid passport
• Valid Yellow fever certification (Compulsory)
• Valid COVID-19 vaccination certification (Optional)
• Work Requirements
• The position will be based in Greenside, Johannesburg, with a hybrid working/home routine
• An active passport and will be required to travel domestically and internationally on a frequent basis
• Professional approach to time, costs, and deadlines
• Ability to handle high workloads and pressure is essential

Remuneration Package

• R35,000 – R40,000 / monthly
• Medical Aid
• Group Life Cover

Applications for this position close on Friday 2 June 2023