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Provider Manager (HMO)
About this role
Kaplo Africa seeks a Provider Manager (HMO) to develop, manage and maintain a high‑quality network of healthcare providers across Benin City and surrounding areas in Edo State. The role ensures enrollees receive accessible, quality and cost‑effective services while upholding regulatory compliance and operational efficiency, and builds strong provider relationships. It targets candidates with substantial experience in healthcare provider relations and HMO operations.
What you would do
- Identify, recruit and onboard healthcare providers to expand the HMO network in Benin City and Edo State.
- Conduct facility assessments and due diligence to evaluate capacity and quality standards.
- Negotiate and manage provider service agreements, tariffs and SLAs; maintain the provider directory.
- Act as the primary contact for providers; foster professional relationships and conduct engagement meetings.
- Monitor provider performance against quality metrics; ensure NHIA compliance and oversee credentialing and audits.
- Collaborate with Claims and Authorization teams to address queries, facilitate authorisations and support enrollee complaints.
What they are asking for
- Bachelor's degree in Medicine, Nursing, Health Sciences, Business Administration or a related field.
- Postgraduate qualification or professional certification in Healthcare Management is an added advantage.
- Minimum of 8 years' relevant experience in healthcare, HMO operations, hospital administration or provider relations.
- Prior experience with HMOs or managed care is highly preferred.
- Strong knowledge of the Nigerian healthcare system, NHIA guidelines and provider contracting practices.
- Proficiency in Microsoft Office and healthcare information systems; strong written and verbal communication, negotiation skills; willingness to travel within Edo State.
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