Provider Manager - Nurse at International Health Management Services Limited

About the Role

We are seeking a dedicated and experienced Nurse to 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

• Bachelor's Degree with 2-5 years of relevant 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