Service Provider Relations Officer (9 Months Fixed Term Contract)

The Service Provider Relations Officer establishes, manages, and strengthens relationships with healthcare service providers to ensure quality delivery, cost control, and member experience. The role supports fraud detection, provider compliance monitoring, and cost containment within the healthcare provider network.

Requirements

• Identify, evaluate, and onboard healthcare service providers
• Negotiate provider contracts, tariffs, and service level agreements
• Maintain an updated provider database
• Structure package pricing for common procedures
• Ensure adequate geographic and specialty coverage
• Serve as the primary liaison between the company and healthcare providers
• Conduct regular provider visits, audits, and performance reviews
• Resolve provider disputes, complaints, and operational challenges
• Monitor provider billing patterns to identify fraud, waste, and abuse
• Ensure compliance with agreed tariffs and contractual obligations
• Support cost containment initiatives
• Conduct facility assessments and compliance audits
• Monitor service quality indicators
• Prepare periodic provider performance and utilization reports
• Educate providers on policy updates and claim submission processes