Provider Manager - Nurse at International Health Management Services Limited

About the Role

• We are seeking a dedicated and experienced Nurseto join our dynamic team.
• The ideal candidate will have a strong background in provider network management and will collaborate closely with our Claims Department and Call Center teams to ensure seamless healthcare service delivery and provider coordination.

Key Responsibilities

• Manage and maintain relationships with healthcare providers in the network.
• Monitor provider performance and ensure compliance with healthcare standards and regulatory requirements.
• Work closely with the Claims Department to review and validate medical claims.
• Support the Call Center team in resolving provider-related inquiries and complaints.
• Ensure adherence to healthcare regulations and internal policy guidelines.
• Participate in the onboarding and credentialing of new providers.

Requirements

• Interested candidates should possess a Bachelor's Degree with 2-5 years experience.
• Strong knowledge of healthcare regulations, policies, and clinical best practices.
• Excellent communication and interpersonal skills.
• Strong analytical and problem-solving abilities.
• Ability to work collaboratively across departments.