Kaplo is Africa's most innovative Human Resource & Business Support Solutions provider, serving clients with cutting-edge business advisory and human capital solutions across diverse sectors of the African economy.
At Kaplo, we have proven expertise in business advisory and human resource capabilities targeted at productivity, profitability, sustainability, transformation and overall growth of your business.
We
are recruiting to fill the position below:
Job Title: Provider Manager (HMO)
Location: Benin City, Edo
Department: Provider Management / Operations
Reports to: Head of Provider Management
Job Purpose
- The Provider Manager is responsible for developing, managing, and
maintaining a high-quality network of healthcare providers (hospitals,
clinics, diagnostic centers, pharmacies, and specialists) within Benin
City and surrounding areas in Edo State.
- The role ensures that enrollees of the HMO receive accessible,
quality, and cost-effective healthcare services while maintaining strong
provider relationships, regulatory compliance, and operational efficiency.
Key Responsibilities
Provider
Network Development & Management:
- Identify, recruit, and onboard new healthcare providers to expand
and strengthen the HMO’s provider network in Benin and Edo State.
- Conduct facility assessments and due diligence visits to evaluate
capacity, quality standards, and suitability.
- Negotiate and manage provider service agreements, tariffs, and
service-level agreements (SLAs).
- Maintain an up-to-date provider directory and ensure accurate
mapping of facilities on the HMO’s systems.
Relationship
Management:
- Serve as the primary point of contact between the HMO and healthcare
providers in the region.
- Build and sustain strong, professional relationships with hospital
management, medical directors, and key clinical staff.
- Conduct regular provider engagement meetings, feedback sessions, and
performance reviews.
- Resolve provider-related issues, complaints, and disputes promptly
and professionally.
Quality
Assurance & Compliance:
- Monitor provider performance against agreed quality metrics,
clinical standards, and HMO guidelines.
- Ensure all providers comply with National Health Insurance Authority
(NHIA) requirements and internal HMO policies.
- Coordinate provider credentialing, re-credentialing, and continuous
quality improvement activities.
- Conduct periodic audits and facility inspections to ensure standards
are maintained.
Claims
& Operational Support:
- Work closely with the Claims and Authorization teams to address
claim-related queries and reduce rejections.
- Facilitate smooth authorization processes and ensure providers
understand the HMO’s clinical guidelines and benefit packages.
- Support the resolution of enrollee complaints related to provider
service delivery.
Reporting
& Analysis:
- Prepare regular reports on network performance, provider
utilization, quality indicators, and expansion progress.
- Analyze provider data to identify gaps, opportunities, and areas for
improvement.
- Provide insights and recommendations to management on network
strategy in the Benin/Edo region.
Other
Duties:
- Support regional marketing and enrollee education activities as
required.
- Represent the HMO at relevant stakeholder meetings and industry
events in the region.
- Perform any other related duties assigned by management.
Key Performance Indicators
(KPIs)
- Growth and retention of active providers in the network
- Provider satisfaction and engagement levels
- Reduction in provider-related complaints and claim disputes
- Compliance rate of providers with quality and contractual standards
- Timely submission of accurate network reports.
Qualifications and
Experience
- Bachelor’s Degree in Medicine, Nursing, Health Sciences, Business
Administration, or a related field.
- A 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 working with Health Maintenance Organisations
(HMOs) or in a managed care environment is highly preferred.
- Strong knowledge of the Nigerian healthcare system, NHIA guidelines,
and provider contracting practices.
- Experience managing relationships with hospitals and healthcare
facilities in Edo State or the South-South region is an advantage.
- Skills and Competencies
- Excellent relationship management and interpersonal skills
- Strong negotiation and contract management abilities
- Good analytical and problem-solving skills
- High level of integrity and professionalism
- Strong written and verbal communication skills
- Ability to work independently with minimal supervision
- Proficiency in Microsoft Office tools and healthcare information
systems
- Willingness to travel within Edo State and occasionally to other
locations.
Salary
N350,000
monthly.
Application Closing Date
30th
September, 2026.
How to Apply
Interested
and qualified candidates should send their CV to: kaploafrica@gmail.com using “Provider Manager
(HMO)n” as the subject of the email.
Note: Only shortlisted candidates will be contacted.
