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Strategic Purchasing Executive at Jubilee Insurance

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Jubilee Insurance was established in August 1937, as the first locally incorporated Insurance Company based in Mombasa in 1937. Jubilee Insurance has spread its sphere of influence throughout the region to become the largest Composite insurer in East Africa, handling Life, Pensions, general and Medical insurance.



Job Ref. No: JHIL091


Role Purpose


As the Strategic Purchasing Executive, you would be responsible for establishing and maintaining relationships with healthcare providers to ensure a robust and high-quality network of medical services for policyholders. This role involves collaboration with internal and external stakeholders to optimize provider partnerships.


Main Responsibilities


Strategy



  • Maintain relationships with Specialists, administrative staff for specialists and other key Specialists’ influencers and provide a clear link between these and Jubilee Health Insurance.

  • Act as a liaison between Specialists and Jubilee Health Insurance limited to resolve problems, provide, and obtain information, and maintain positive working relationships with Specialists.


Operational



  • Negotiation of cost of services rendered by medical providers.

  • Monitoring Average Costs of providers and engaging high-cost providers for cost reduction.

  • Implement initiatives that help reduce the cost of drugs such as drug delivery, generic drugs utilization among others.

  • Develop a tracking system for and ensure timely follow-up of doctors’ payments is done.

  • Ensuring all cost Agreements have been Setup in the System, i.e., Co-pays, Discounts, Micro Schemes and Restricted Categories/Providers.

  • Provide guidance to the care management team, claims team, and contact center agents on provider cost issues.

  • Support the business development and underwriting team in client servicing.

  • Monthly reports on effectiveness of systemized cost control and saving achieved.

  • Pre-authorisations monitoring to determine IBNR.

  • Providing a report on claims status. Indicating outstanding claims, assessed and registered claims.

  • Link, guide and communicate with prospective specialists through the credentialing process.

  • Document all Specialists office interactions and other pertinent information in applicable databases to provide an accurate record of Specialist encounter history.


Corporate Governance



  • Assist in carrying out country-wide provider audits to ensure that quality, cost effective medical services can be guaranteed for clients.


Leadership & Culture



  • Promote a customer-centric approach to provider partnerships, prioritizing policyholder satisfaction and positive health outcomes.

  • Collaborate with internal stakeholders to drive cultural transformation and organizational alignment around provider partnership goals and strategies.


Requirements


Key Competencies



  • Negotiation

  • Performance reporting and management.

  • Relationship Building skills

  • Health Benefit Plan Management.


Qualifications



  • Diploma in Nursing/Diploma in Clinical Medicine & Surgery

  • Basic understanding of the concepts of insurance

  • Proficient in the use of Microsoft office suite and packages


Relevant Experience



  • Minimum of 2 years of relevant working experience in Case Management




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