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
Case management & pre-authorization
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
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 reports
Any other duty as may be assigned by the supervisor
Key Competencies
Knowledge And Skills Required
Clinical /medical background & knowledge
Data analytics & computer literacy
Flexibility
Teamwork
Time Management
Excellent verbal and written communication skills
Solution oriented
Professional and Academic Qualifications
The job holder must possess:
Diploma in nursing or clinical medicine
B.Sc. health systems management will be an added advantage
Two (2)years’ experience in health insurance operations
Application Deadline
Tuesday, 11, Jul, 2023
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