Summary
Date Posted: Thursday, June 09, 2022 , Base Salary: Not Disclosed

JOB DETAILS:
Company description
• Britam is a leading diversified financial services group, listed on the Nairobi Securities Exchange. The group has interests across the Eastern and Southern Africa region, with operations in Kenya, Uganda, Tanzania, Rwanda, South Sudan, Mozambique and Malawi. The group offers a wide range of financial products and services in Insurance, Asset management,

Job Purpose:
• Control and managing of the policy cycle through pre-authorization and case management, to ensure quality and cost-effective care.
Key responsibilities
• Set the appropriate parameters for each admission (claim reserve, initial authorized cost, and duration)
• Interact with clients and service providers to ensure that the care is given within policy guidelines
• Review medical reports and claims for compliance with set guidelines
• Liaise with underwriters on the scope of cover for the various schemes
• Ensure that medical scheme members are attended to round the clock with support from a 24-hour call center.
• Poly-Pharmacy – discourage poly-pharmacy by diligent challenging prescriptions and suggesting better alternatives.
• Generic substitution – Encourage the use of generics where indicated as a method of reducing the organization's pharmaceutical expenditure.
• Prepare periodic reports for management on medical claims

Knowledge, experience and qualifications required
• Diploma/Degree in Nursing or Diploma in clinical medicine or Diploma in Pharmacy.
• Moderate understanding of insurance concepts
• Professional qualification in FLMI, ACII and IIK.
• 5-8 years’ experience in case management two of which should be in a supervisory position


Work Hours: 8

Experience in Months: 60

Level of Education: Bachelor Degree

Job application procedure

Interested and qualified https://www.myjobmag.co.ke/apply-now/398009 


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