Team Leader: Provider Relationship Specialist

  • Full-time

Company Description

Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change. Kaelo meets the Healthcare needs of Corporate and Retail clients across South Africa – products offerings include Medical Insurance, Medical Aid, Gap Insurance, Kaelo Money and employee assistance programmes.

Job Description

The Provider Relationship Specialist Team Leader is responsible for the day to day management of the multi-disciplinary network. Ensuring that contractual obligations with medical schemes, insurance and primary care products are established and maintained. Maintaining strong relationships with DSP’s via periodic engagement and implementation of standards and to manage and maintain quality assurance checks. Query resolution and effective interaction management. Manage contracts and service level agreements, through effective reporting and administration.

Ensure that each service level agreement is adhered to and met by the relevant business unit owner

Monitor trends within the business that may adversely affect the SLA and ensure the line manager and relevant business unit owners are kept informed

Ensure all queries are dealt within contracted SLA all stakeholder are kept informed of relevant progress work items or escalations

KEY OUTCOMES (not limited to)

  • Set clear objectives, define roles and responsibilities, and ensure each team member aligns with the team’s vision.
  • Communicate expectations, goals and feedback to the group regularly and resolve any concerns or issues actively.
  • Identify and address conflicts early, facilitating discussions and finding satisfactory solutions for all parties involved.
  • Support team members’ professional development by providing opportunities for training and growth.
  • Ensure team compliance with company policies and procedures.
  • Support, monitor and guide team members to ensure they meet their individual targets and KPIs.
  • Generate reports on team performance and provide regular updates to senior management.
  • Monitoring overall team performance and maintaining a report. Constantly keeping team members motivated to deliver their best.
  • Set the tone for the team and create a positive and productive work environment.
  • Developing objectives for the team to work towards and achieve company goals.
  • Monitor system performance and report on any system issues that may arise.
  • Compile daily stats
  • Attend to Escalations from other departments
  • Informing senior management and escalating tasks, as necessary.
  • Report to the Network Manager

 

Qualifications

PERSON DETAILS : WORK EXPERIENCE

REQUIRED

At least 2 years administrative network experience

PREFERRED

EDUCATION: QUALIFICATIONS : ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED

Matric

PREFERRED

TECHNICAL SKILLS OR KNOWLEDGE

REQUIRED

MIP / Microsoft Office / Putty

Additional Information

PERSONAL ATTRIBUTES: BEHAVIORAL COMPETENCIES

Resilience

Customer Focus

Emotional Intelligence

Strategic Relationship Building

Communication Skills (incl. listening)

Conflict Management

Passion for Results

Deadline Driven

Coaching and Developing Others