They shall be responsible for:
Developing wellness programs and customise wellness programs based on clients needs.
Coordinating wellness health screenings, physical exams, and other diagnostic tests for patients at Equity Afia medical centres
Coordinating health education/ health promotion for our clients on topics related to wellness such as stress management, nutrition, smoking cessation, exercise, healthy lifestyle changes, among others.
Managing employee health plans on behalf of our clients to ensure that they meet all regulatory requirements
Coordinating medical examinations at Equity Afia medical centers as recommended by insurance and corporates for life and medical covers
Vetting and confirming validity of the service given by the service provider (Equity Afia) in relation to the benefits covered, treatment given, adherence to payer/insurance panel rules and cost of treatment.
Obtaining additional required information on claims from providers, brokers, or clients, seeking medical clarifications including medical reports, copies of investigation reports, etc.
Liaising with insurance providers on scope of cover for various schemes
Assisting in conducting provider (Equity Afia medical centres) audits whenever necessary.
Liaise with the insurance claims assessor(s) for outpatient claims from Equity Afia medical centres and coordinating on any information required to validate the claims.
Interacting with clients, brokers, payers, and clinicians as needed, to resolve problems in a manner that is legal, ethical, and consistent with the principles and policies of Equity Afia
Identify & leverage on opportunities for continuous quality improvement and process reengineering to optimize operational efficiency and patient care at the Equity Afia facilities
Key Deliverables for this position
Support in business acquisition and renewal with corporates/insurance providers
Delivering well administered Wellness/Medical examination programs for our clients
Liaison for Equity Afia and insurance companies/ corporate clients, performing care management functions to ensure accurate and timely dissemination of information to insurances companies/ corporate clients
Qualifications
Diploma in Clinical Studies (Nursing/Clinical Medicine/Nutrition/Physiotherapy/Public health) or any other health related studies
Course in Wellness/Health Education/Health promotion/ will be an added advantage.
Minimum of 5 years’ relevant experience in a similar role.
Basic Understanding of the Concepts of Insurance.
Proficient in the use of Microsoft Office Suite and Packages.
Excellent interpersonal skills
Possess the ability to build personal relationships with key business stakeholders and have distinguished hands-on operational skills
Deadline: 25th May 2022
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