A leading organisation in the Healthcare Service Industry is seeking to recruit highly qualified individuals to join our team. Applications are invited from suitably qualified and experienced candidates for the above-mentioned positions.
Key Responsibilities
Case Coordinator
- Assists in the profiling of specialty institutions for prioritisation in management of members based on quality outcomes and afford ability;
- Establishes actual and potential health problems, goals for treatment and desired outcomes using the nursing process;
- Provides customer support through member education on hospital benefits, preauthorization processes, and discharge planning.
Provider Queries Officer
- Communicates outcome of queries through email or telephone daily to members and service providers;
- Ensures availability of up to date reports on provider claims submitted, payments, and arrears;
- Applies information technology to improve service provider network coordination.
Healthcare Coach
- Provides effective solutions and suggestions on health and fitness issues;
- Suggests exercises, diet charts, meditation or mental stress reducing techniques to members;
- Promotes member self-management and empower members/families to achieve maximum levels of wellness and independence.
Provider Network Officer
- Participates in provider mapping in line with set guidelines to ensure adequate access to care for members;
- Participates in evaluation of provider performance in line with agreed utilization management metrics;
- Attends to provider issues/queries including claims, utilization, member grievances and inquiries in a timely and professional manner.
Job Summary
More Information
- Job Application Details Persons Specification:- Diploma in General Nursing; At least 3 years'experience in nursing; Hands on hospital experience; Excellent computer skills. If you are qualified and interested, please email your application together with your detailed CV by not later than Friday 5 February 2021 to [email protected] N.B. Only short listed applicants will be responded to.