SUMMARY:
Our client is looking for a Hospital Network Service Provider to join their team in Mauritius.
POSITION INFO:
Roles and Responsibilities
Provider & Assistance Responsibilities
Act as the primary liaison between Unisure and hospital administrators, ensuring smooth communication and resolution of issues.
Build and maintain strong relationships with healthcare providers through regular engagement and on-site visits.
Ensure timely and accurate feedback from hospitals on member cases, especially inpatient admissions.
Support pre-authorization workflows and SMART OPD operations to ensure process efficiency.
Assist with onboarding and training of new providers, ensuring alignment with Unisure’s service standards.
Monitor service delivery standards and escalate issues that affect member experience.
Provide operational support for network expansion and service improvement initiatives.
Support medical evacuations or complex assistance cases in Mauritius by coordinating between providers and Unisure’s Assistance team.
Insurance & Operational Responsibilities
Verify hospital and provider invoices against member benefits, policy terms, and agreed tariffs.
Ensure that all claims documentation from providers is complete, accurate, and submitted within agreed timelines.
Monitor adherence to agreed tariffs, discounts, and contractual arrangements with providers.
Escalate irregularities in claims, billing, or provider practices to the Network & Assistance Services team.
Collaborate with the Claims and Underwriting teams to provide local insights on medical costs, treatment patterns, and fraud risks.
Support provider contract negotiations by gathering intelligence on market practices and competitor arrangements.
Maintain up-to-date records of provider contracts, agreements, and contact details.
Provide reporting and analysis on provider performance, case turnaround times, and service delivery trends.
Ensure compliance with local healthcare regulations and Unisure’s internal policies.
Contribute to the development of member communication guidelines for hospital admissions, approvals, and discharge processes.
Personal Attributes:
Strong interpersonal and relationship-building skills.
Excellent communication and negotiation abilities.
Organised, detail-oriented, and able to work under pressure.
Problem-solving mindset with the ability to escalate appropriately.
Customer-focused, with a commitment to delivering a high-quality member experience.
Proficiency in MS Office (Word, Excel, Outlook, PowerPoint).
Qualifications & Experience:
Experience working across international markets is an advantage.
Bachelor’s degree in healthcare management, business administration, or a related field (preferred).
Prior experience in healthcare, medical assistance, insurance, or provider network management.
Familiarity with international private medical insurance (IPMI) operations will be an advantage.
Bilingual fluency in English and French (written and spoken) required.
Key details:
Monthly salary range: MUR 35,000 – 55,000
20 days annual leave per annum
15 days paid sick leave per annum
Must be fluent in both French & English
Excellent people and interpersonal skills
Background in healthcare, medical assistance, or insurance
Role is based in Mauritius
Employment Details
Employment Type:
Permanent Employment
Industry:
Health and Welfare
Work space preference:
Work Onsite
Ideal work province:
Southern Africa
Ideal work city:
N/A
Salary bracket:
R 0 - 0
Drivers License:
CODE B (Car)
Own car needed:
Yes
