Summary
Date Posted: Friday, July 07, 2023 , Base Salary: Not Disclosed

JOB DETAILS:

Purpose for the Job
The main purpose for the job is to ensure that Minet clients receive quality healthcare at the most reasonable cost, enhance customer experience and offer clinical support to the business.

Duties and Responsiblities
• Supervise and support pre-authorization and care management functions to ensure accurate decisions on levels of care and appropriate treatment to patients.
• Ensure timely adjudication and issuance of approval letters as per policy guidelines
• Ensure that all admitted patients are visited and case management process is compliant to ISD protocol
• Management of Special Cases & Arbitration
• Management of ACOS & ALOS
• Manage local and abroad evacuations
• Cost containment
• Enforcement of rates
• Discount negotiations
• Client advisory
• Step down management,
• Discharge planning,
• Homecare management
• Call Centre Management - Effective management of the 24-hour call centre.
• Ensure seamless access to care
• Professional, accurate and timely responses to clients.
• Attend to customer feedback/complaints
• Timely escalation and reporting of any incidences
• Maintain desired call drop rate
• Enhance Customer Experience
• Establish and maintain good relationships with internal and external stakeholders such as health care service providers, insurers, contracted providers etc.
• Referral to CDM Programs - process management
• Preparation of relevant management/ business reports
• Provide direction, coaching, mentorship and motivation to the direct reports and their team members
• Any other duty as may be assigned by the supervisor

Key Competencies
Knowledge And Skills Required
• Clinical /medical background & knowledge
• Data analytics & computer literacy
• Time management
• Excellent verbal and written communication skills
• Solution oriented
• 5 years of experience in health insurance operations 3 of which must be in a managerial role

Professional and Academic Qualifications
The job holder must possess:
• BSc. Nursing , Clinical Medicine, B.Sc. Health systems management
• Professional qualification in insurance will be an added advantage



Work Hours: 8

Experience in Months: 60

Level of Education: Bachelor Degree

Job application procedure

Interested and qualified? Click here to apply


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