Medical Providers Management

About Nextcare

Nextcare stands as a premier Third Party Administrator (TPA) for the insurance sector throughout the GCC and MENA regions, specializing in extensive health insurance management since 1999. The company prides itself on delivering excellent customer service, optimizing costs, and adhering strictly to compliance standards. Operating the region’s first 24/7 medically staffed multilingual call center, Nextcare services a wide network with cashless facilities spanning multiple countries. With over 4 million members and claims surpassing USD 1 billion annually for more than 120 clients, Nextcare is a proud member of the Allianz Group and employs upwards of 1,100 professionals across various countries including the UAE, Lebanon, KSA, Egypt, Bahrain, Oman, Qatar, Kuwait, Morocco, and Tunisia. The company was honored as "TPA of the Year" at the Middle East Insurance Industry Awards 2016.

Role Overview

The Medical Providers Management position is a fully remote, full-time role dedicated to supervising the relationships and operational standards of Nextcare’s medical provider network. Responsibilities range from onboarding and credentialing providers to maintaining updated provider records and ensuring compliance with contractual obligations and quality benchmarks.

The role includes coordinating directly with providers to address billing questions, resolve claim disputes, and uphold service quality. It plays a critical part in promoting cost control and ensuring adherence to regulatory and internal policies. Working closely with claims, customer service, and medical review teams, the position handles escalations to improve provider engagement and network efficiency. Monitoring performance indicators, compiling reports, and suggesting enhancements to network strategies and managed care programs are key functions of this role.

Qualifications

• Proven experience in managing medical provider networks, healthcare administration, or insurance operations—preferably within TPA or health insurance sectors.
• Exceptional skills in managing relationships, stakeholder communication, and conflict resolution with healthcare providers and internal units.
• In-depth understanding of claims procedures, medical billing standards, and healthcare regulations across GCC, MENA, or comparable regions.
• Strong analytical capabilities for interpreting provider performance data, spotting trends, and aiding cost optimization and quality improvements.
• Proficiency with healthcare or insurance management software, CRM tools, and standard office applications like Excel, PowerPoint, and databases.
• Fluent communication skills in English, with additional proficiency in regional languages such as Arabic or French considered advantageous.
• Capacity to work autonomously in a remote setting, efficiently handle multiple tasks, meet deadlines, and maintain meticulous attention to detail.
• A Bachelor’s degree in Healthcare Administration, Business, Insurance, or relevant fields is required; professional certifications related to health insurance or provider management are advantageous.