Provider Manager (HMO)

Kaplo Africa | Lagos, Nigeria

Full-time Posted today 0 views

About the Role

Kaplo Africa is Africa's most innovative Human Resource and Business Support Solutions provider, dedicated to driving productivity, sustainability, and growth for our clients. We are currently seeking a dynamic and experienced Provider Manager (HMO) to oversee, develop, and maintain a robust network of healthcare providers in Benin City and surrounding areas across Edo State. In this pivotal role, you will ensure our enrollees receive accessible, high-quality, and cost-effective healthcare while fostering strategic partnerships with hospitals, clinics, and medical professionals.

Key Responsibilities
  • Identify, recruit, and onboard new healthcare providers to expand the HMO's network strength in Benin City and Edo State.
  • Negotiate and manage provider service agreements, tariffs, and comprehensive service-level agreements.
  • Serve as the primary liaison between the HMO and regional healthcare providers, resolving disputes and complaints promptly.
  • Monitor provider performance against clinical standards, quality metrics, and regulatory requirements including NHIA guidelines.
  • Collaborate with claims and authorization teams to streamline processes, reduce rejections, and improve operational efficiency.
  • Conduct periodic facility audits, inspections, and continuous quality improvement activities.
  • Prepare comprehensive reports on network performance, utilization trends, and expansion progress for management.

Qualifications
  • Bachelor's degree in Medicine, Nursing, Health Sciences, Business Administration, or a related field.
  • Minimum of 8 years of relevant experience in HMO operations, hospital administration, or provider relations within the Nigerian healthcare sector.
  • Postgraduate qualification or professional certification in Healthcare Management is an added advantage.
  • Deep understanding of the Nigerian healthcare landscape, NHIA guidelines, and healthcare contracting practices.
  • Familiarity with the healthcare market in Edo State and the broader South-South region is highly preferred.
  • Exceptional negotiation, relationship management, and communication skills with high integrity and professionalism.
  • Proficiency in Microsoft Office suite, healthcare systems, and a willingness to travel locally for provider visits.

Benefits
  • Competitive salary and performance-based incentives.
  • Comprehensive health insurance and wellness benefits.
  • Opportunities for professional growth, continuous learning, and career advancement within a leading African organization.
  • A collaborative, dynamic, and impact-driven work culture.

Skills

Provider Management HMO Operations Contract Negotiation Healthcare Administration Relationship Management Quality Assurance NHIA Compliance Claims Support
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