Provider Administrator Job description sample
This Provider Administrator Job description sample can assist in your creating a job application that will attract job candidates who are qualified for the job. Feel free to revise this job description to meet your specific job duties and job requirements.
Job Title: Provider Administrator
Job Objective(s)
- Provider prospecting (visitation, phone calls and e-mails)
- Documentation and filing of Prospective and available providers
- Handling Call Centre and issuing authorization code when needed
- Provider quality assessment
- Case Management
Specification/Qualification Requirement:
- Qualification: Minimum of the first degree, a Master’s degree would be an added advantage
- Age: Between 25 and 45 years.
Experience Required:
- Minimum of 2 years post qualification experience in a similar role in the Health Maintenance Organization (HMO) or handling HMO desk in a Hospital.
Professional Membership:
- Professional qualification in Management is an added advantage
Reporting Relationship:
- Reports to: Head, Medical Operations
- Supervises: Front desk staff
Job Responsibilities
- Provider Relationship Management
- Provider Identification, Profiling and Activation management(filing and record-keeping)
- Provider visitation, audit and capacity evaluations.
- Assist and follow up on provider tariff review, negotiation and implementation for prospective providers
- Provider network quality assurance, profitability assessment and banding.
- Coordination of Care access and referral mechanism
- Promotion of cordial relationship between Clients and Providers
- Provider and Clients Education and enlightenment.
- Provider satisfaction survey, feedback and analysis
- Scouting for and activating new HCPs and managing all providing filing systems both online and hard copy
- Handle call centre calls and give email approvals for procedures or issuance of verbal Pre-Authorization codes as the case may
- Any activity assigned by Management
Units Under Provider Administration
- Provider Management
- Call centre
Competence Requirements:
Core Skills:
- Planning and Strategy
- Provider prospecting
- Provider management
- Document filing and record-keeping
- Provider visitation
- Research
- Decision-Making Skills
- Negotiation Skills
- IT Applications in business and customer service
Generic Skills
- Organisation Context
- Leadership
- Communication
- Presentation Skills
- Relationship Management Skills
- Emotional Intelligence
- Analytical skills
- Interpersonal Skills:
- Environmental awareness
- Performance Management
- Office productivity IT tools
- Fiscal Management
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