Outbound Relationship Specialist X2 – Job Post

Company: Kaelo

Location: Johannesburg, Gauteng 2196

Job Type: Full-time

Company Description:

Kaelo provides essential healthcare solutions to ensure the physical and psychosocial well-being of all South Africans, driving lasting social change. We meet the healthcare needs of corporate and retail clients nationwide, offering medical insurance, medical aid, gap insurance, Kaelo Money, and employee assistance programs.

Job Description:

The Outbound Relationship Specialist is responsible for managing the multi-disciplinary network, including contractual obligations with medical schemes, insurance, and primary care products.

The role involves maintaining strong relationships, implementing standards, ensuring quality assurance, resolving queries, and effectively managing interactions. Contract and service level agreement management through reporting and administration is also part of the role, along with educating our network on benefits, processes, and systems.

Key Outcomes:

• Developing interpersonal business relationships with network providers and internal partners
• Meeting targets and regulatory requirements
• Understanding provider administration systems for claims submission
• Resolving provider issues
• Knowledge of POPIA and its application in day-to-day functions
• Proficiency in MS Office, especially intermediate-level skills in Excel
• MIP System experience

Responsibilities:

• Developing, maintaining, and managing stakeholder relationships
• Working on multiple projects
• Collaborating with key stakeholders and departments
• Ensuring appropriate distribution of healthcare providers in the network
• Maintaining and enhancing healthcare provider networks
• Participating in cross-functional teams for system and policy development
• Increasing quality and productivity through action plans
• Managing relationships across provider networks

Reporting:

• Compiling daily, monthly, quarterly, and ad hoc reports accurately and submitting them internally and externally by agreed deadlines
• Collecting data for reports to Divisional Head Network and Risk executive
• Conducting monthly quality audits on network-related SOPs

Qualifications: Special Requirements:

• Ability to maintain confidentiality, problem solve, negotiate, and communicate

Person Details: Work Experience: Required:

• Ability to work independently and with minimal supervision
• Strong judgment and discretion
• Excellent oral and written communication skills
• Outstanding customer service and computer skills
• Ability to handle pressure and remain calm, friendly, and professional
• Willingness to travel 90%-100%

Preferred:

• Proven work experience in a client or provider management role
• Minimum of 6 years’ experience in the South African healthcare market

Education: Qualifications: Accreditations with Professional Body: Required:

• Matric
• FAIS Compliance
• RE 5 and Class of Business
• Valid Driving License
• Own Transport

Technical Skills or Knowledge: Required:

• Computer Literacy: Microsoft Excel, Word, and PowerPoint
• Strong phone and email communication skills

Preferred:

• Knowledge of the Medical Scheme Industry
• MIP and Putty knowledge would be an advantage

Additional Information: Personal Attributes: Competencies:

• Accountability
• Action orientation
• Business writing skills
• Communication
• Encourages engagement
• Manages complexity
• Planning and organization
• Problem-solving skills
• Purpose-driven
• Resilient and adaptive
• Significance and values orientation
• Systems thinking and connecting ability