Provider Liaison Officer – Healthcare Management

About the role

The Provider Liaison Officer supports the Manager of the Provider Liaison Office within GEMS' Healthcare Management Division. Based in Gauteng Province, the role focuses on fostering strong relationships with contracted Managed Care Organisations and ensuring compliance with scheme agreements.

Key responsibilities

• Assist the Manager in overseeing contracted Managed Care Organisations.
• Review provider efficiency reports and provide commentary on network service quality and compliance.
• Represent the Healthcare Management Division at stakeholder engagements and promote network participation.
• Prepare periodic reports on stakeholder engagements for senior management.
• Deliver continuous education on GEMS strategy, systems, processes and products to providers in the assigned region.
• Act as the single point of contact for escalations related to claims and authorisations from providers.
• Provide secretariat support for provider relations meetings.
• Support other scheme divisions in managed‑care activities as required.

Required profile

• At least a NQF Level 6 (Diploma/Degree) in Clinical Sciences or a related field.
• Minimum of five years’ experience in the healthcare funding/medical‑scheme industry.
• Proven experience in provider‑relations management; case or claims management experience is advantageous.
• Strong quantitative and qualitative analysis abilities with attention to detail.
• Excellent communication, writing and project‑management skills.
• Self‑starter with reliable work ethics and the ability to work well in a team.
• Own transport is essential.

Required skills

• MS Office proficiency

What we offer

• Annual remuneration of R978 410, negotiable based on qualifications and experience.
• Opportunity to work within a reputable healthcare management team.