Reliance Health uses Technology to Make Healthcare Accessible and Affordable. Through an integrated approach that includes affordable health insurance, telemedicine, and a combination of partner and proprietary healthcare facilities, Reliance Health offers innovative healthcare solutions that meet the needs of emerging markets.
We are recruiting to fill the position below:
Job Title: Director of Claims and Tariff Management
Location: Lagos (Remote)
Employment Type: Full Time
Key Responsibilities
- Cost Reduction and Fast Reimbursement Cycles: Implement strategies to reduce costs and ensure rapid reimbursement cycles for claims across all active markets, enhancing overall operational efficiency and customer satisfaction.
- Efficiency Improvement and Unpaid Claims Reduction: Oversee initiatives to enhance the efficiency of claims and optimize team productivity and processing systems to reduce unpaid claims backlogs and streamlining workflows for faster adjudication.
- Automation and Rules-Based Claims Processing: Lead the improvement of rules-based automated claims processing engines, leveraging technology to enhance accuracy, speed, and consistency in claims adjudication.
- Prior Authorization Enhancement: Enhance the accuracy and turnaround time for complex prior authorization requests, ensuring timely access to necessary healthcare services for our members.
- Cost Reduction and Fast Reimbursement Cycles: Implement strategies to reduce costs and ensure rapid reimbursement cycles for claims across all active markets, enhancing overall operational efficiency and customer satisfaction.
- Efficiency Improvement and Unpaid Claims Reduction: Oversee initiatives to enhance the efficiency of claims and optimize team productivity and processing systems to reduce unpaid claims backlogs and streamlining workflows for faster adjudication.
- Automation and Rules-Based Claims Processing: Lead the improvement of rules-based automated claims processing engines, leveraging technology to enhance accuracy, speed, and consistency in claims adjudication.
- Prior Authorization Enhancement: Enhance the accuracy and turnaround time for complex prior authorization requests, ensuring timely access to necessary healthcare services for our members.
Requirements
- MBBS or Bachelor’s Degree in Healthcare Administration, Business Management, with a preferred background of master’s level studies in data analysis or business administration
- 8+ years of experience in claims management and tariff negotiation within the healthcare industry
- Proven track record of implementing process improvements to enhance claims efficiency and reduce costs.
- Strong background in data analysis and demonstrated ability to work with data to solve complex problems, utilizing advanced analytical tools and methodologies
- Strong understanding of rules-based automated claims processing systems and prior authorization workflows.
- Experience in tariff negotiation, provider network management, and benefits design across diverse markets.
- Excellent leadership and communication skills, with the ability to collaborate effectively across cross-functional teams.
- Analytical mindset with proficiency in data-driven decision-making and performance metrics evaluation.
Benefits
At Reliance Health, we prioritize our people and their well-being. Our benefits package is designed to support your success, growth, and happiness. Here’s what you’ll enjoy:
Hybrid, Flexible Environment:
- Experience the best of both worlds with our hybrid setup—work from home when you need focus, and connect with a vibrant, collaborative team in the office.
Competitive Salary and Benefits:
- We offer a salary that’s benchmarked against the best in the industry, ensuring your expertise and impact are fully rewarded.
Premium Health Insurance:
- Comprehensive health coverage for you and your family, because your well-being comes first.
Unlimited Leave:
- Take the time you need when you need it—no limits, no questions.
Meaningful Impact:
- Play a key role in transforming customer experiences and shaping healthcare innovation.
Collaborative Work Culture:
- Join a supportive, inclusive, and team-focused environment that celebrates diversity.
Growth Opportunities:
- Access tools, mentorship, and resources to elevate your skills and career.
Learning & Development Allowance:
- We provide an allowance to support your ongoing professional growth and skill enhancement.
How to Apply
Interested and qualified candidates should:
Click here to apply online
Application Closing Date
Not Specified.
