Purpose for the Job
To link Minet and all clients covered under Minet managed medical care schemes, ensuring that agreed care packages/residential/nursing placements are administered.
Duties and Responsiblities
Operational Roles and Responsibilities
Case Management through daily hospital visits and patient reviews
Costs negotiations with providers for hospitalized members
Vetting of bills to ensure no double billing and proper application of agreed packages and price lists
Seamless facilitation of evacuations by road or air
Discount negotiations and step-down implementation
Facilitation of all in-patient admissions and discharges by ensuring prompt preauthorization and preparation of bills
Escalate well-certified cases in need of overseas evacuation to the preauthorization team
Fraud detection and management
Service provider relations and training
Identification of medical service providers for accreditation and coordinating collection of all relevant accreditation documents as guided by the Service Provider team
Member sensitization and wellness activities within the county
Organize Stakeholder engagement programs such as courtesy visits, training, and County Governance forums
Preparation of reports such as Case Management notes, member sensitization reports, and county incident reports as per agreed timelines
Any other duty as may be assigned by the supervisor
Key Result Areas
Customer Service.
Policy guidance.
Care options information.
Discount negotiations/Cost Control.
Medical guideline orientation.
Key Competencies
Case management.
Benefit coordination.
Stakeholder management.
Conflict resolution.
Public Speaking.
Knowledge And Skills Required
At least 3 years’ experience in relevant field.
Communication skills.
Detail oriented.
Interpersonal skills.
Negotiations skills.
Professional and Academic Qualifications
A minimum of a Diploma in Clinical Medicine.
A degree in a related field such as Clinical Medicine or Health Systems Management will be an added advantage.
Apply via :
hr.minet.co.ke