Secure the HMO Provider Manager role at Kaplo Africa

About Kaplo Africa

Kaplo is Africa’s most innovative Human Resource & Business Support Solutions provider. Kaplo serves clients with cutting-edge business advisory and human capital solutions across diverse sectors of the African economy. Kaplo has proven expertise in business advisory and human resource capabilities. It focuses on productivity, profitability, sustainability, transformation, and the overall growth of the businesses it works with. Our team ensures Maintenance of hospital facilities is considered in relevant client guidance.

Kaplo Africa is currently recruiting to fill the position below:

Job Overview

Job Title: Provider Manager (HMO). Location: Benin City, Edo State. Department: Provider Management / Operations. Reports to: Head of Provider Management. Salary: N350,000 per month. Application Closing Date: 10th September, 2026.

Job Purpose

The Provider Manager is responsible for developing, managing, and maintaining a high-quality network of healthcare providers — including hospitals, clinics, diagnostic centers, pharmacies, and specialists — within Benin City and surrounding areas in Edo State. In simple terms, this role acts as the bridge between the Health Maintenance Organization (HMO) and the healthcare facilities that actually deliver care to enrollees. The Provider Manager ensures that enrollees receive accessible, quality, and cost-effective healthcare services, while maintaining strong provider relationships, regulatory compliance, and operational efficiency across the network.

Key Responsibilities

Provider Network Development & Management

• Identify, recruit, and onboard new healthcare providers to expand and strengthen the HMO’s provider network across Benin City and Edo State.
• Conduct facility assessments and due diligence visits to evaluate each provider’s capacity, quality standards, and overall suitability.
• Negotiate and manage provider service agreements, tariffs, and Service-Level Agreements (SLAs) — the contractual terms that define expected service standards between the HMO and its providers.
• Maintain an up-to-date provider directory and ensure accurate mapping of facilities within 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 internal HMO guidelines.
• Ensure all providers comply with National Health Insurance Authority (NHIA) requirements, as well as internal HMO policies — NHIA is the regulatory body overseeing health insurance standards in Nigeria.
• Coordinate provider credentialing and re-credentialing — the process of verifying that a healthcare provider meets required qualifications and standards — along with continuous quality improvement activities.
• Conduct periodic audits and facility inspections to confirm that standards are consistently maintained.

Claims & Operational Support

• Work closely with the Claims and Authorization teams to address claim-related queries and reduce claim rejections.
• Facilitate smooth authorization processes and ensure providers clearly 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 network expansion progress.
• Analyze provider data to identify gaps, opportunities, and areas for improvement.
• Provide insights and recommendations to management on network strategy across the Benin City/Edo region.

Other Duties

• Support regional marketing and enrollee education activities as required.
• Represent the HMO at relevant stakeholder meetings and industry events within the region.
• Perform other related duties as assigned by management.

Key Performance Indicators (KPIs)

• Growth and retention of active providers within 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

Educational Qualification:

• 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.

Experience:

• A minimum of 8 years’ relevant experience in healthcare, HMO operations, hospital administration, or provider relations.
• Prior experience working with Health Maintenance Organizations (HMOs) or within 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.

Why This Role Matters

The strength of an HMO depends on the provider network’s quality and reliability.

That network is where care actually happens.

A skilled Provider Manager doesn’t just recruit hospitals and clinics.

They ensure providers meet quality standards, comply with regulations, and deliver trustworthy care.

This role supports Maintenance of hospital facilities by ensuring quality providers meet standards.

It sits at the intersection of healthcare, relationship management, and regulatory compliance.

It links the HMO’s promises with actual care patients receive in Benin City and Edo State.

How to Apply

Interested and qualified candidates should send their CVs to kaploafrica@gmail.com, using “Provider Manager (HMO)” as the subject of the email.

Application Closing Date: 10th September, 2026.

Note: Only shortlisted candidates will be contacted.

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