Quality Assurance Nurse(Osun) at Stresert Services Limited

Job Overview

Location
Lagos, Lagos
Job Type
Full Time
Date Posted
1 year ago

Additional Details

Job ID
115050
Job Views
55

Job Description






REF NO: QAN-OS-24 



Job Responsibilities




  • Attend to and resolve all enrollees’ enquires and ensure that all complaints are promptly resolved on first call resolution, or immediately escalated to the appropriate group or unit.

  • Meticulously log all for management analysis and documentation for all relevant stakeholders.

  • Follow-up on specific cases as assigned by the line manager for measurable outcomes and stakeholders’ satisfaction.

  • Actively and proactively engage in the vetting of bills from the organization’s network of facilities providing secondary/tertiary healthcare services on the public sector social health insurance program

  • Benchmark all received claims with the pre-authorized codes given by call center as any service provided by any facility without pre-authorized code is considered null and void.

  • Review all the received bills and possibly contact the enrollees for authorization of services provided.

  • Investigate and report any incident of abuse, neglect or maltreatment of enrollees immediately to the Management for appropriate actions to be taken.

  • Follow up on enrollees on admission to evaluate and document their progress and possibly assist the care team with developing and accessing health interventions.

  • Participate in case management through scheduled and unscheduled visitation to enrollees on admission.



Education




  • Graduate Professional Nurse and First Degree from an accredited Baccalaureate Nursing Program (University)

  • Must be a registered and licensed practitioner.

  • Possession of recognized additional training in primary health care and midwifery is desirable.



Experience




  • Applicants must have at least 2 years experience as a Nurse and Midwifery Professional.

  • Ability to work seamlessly with Computer and other communication equipment and software.



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