• Application Deadline: Thu, 15 May 2025 00:00:00 GMT
• Position: Medical Manager



• Job Type Full Time



• Qualification BA/BSc/HND



• Experience 8 - 10 years



• Location Lagos




• Job Field Medical / Healthcare 
  
  

QUALIFICATION:

• MBBS, MPH

EXPERIENCE:

• 8 10 years’ relevant work experience.

MAJOR DUTIES/RESPONSIBILITIES

• Ensure best practices are adhered to in quality of care administered to enrolees following standard treatment guidelines and protocols. 


• Coordinate Claims processors work process. 


• Authorize/vet NHIA and PHIS claims according to agreed tariff, Health guidelines and protocols.


• Engage in provider forum. 


• Conduct providers’ satisfaction survey biannually.


• Provide quality assurance support in re-accreditation/accreditation of providers


• Visit of enrollee with serious medical condition to confirm quality of care.


• Provide support for the development of benefit packages 


• Track and manage fraudulent codes.


• Participate in medical outreach, wellness and health seminar for clients.


• Collaborate with other departments.


• Medical verification of bills to ensure adequate treatment.


• Monitor mode and manner of medical care rendered by providers. 


• Participate in reconciliation of payments with providers 


• Train and develop in-house medical operation capacities with current best practice.


• Checking enrollee status and approval.

REQUIRED SKILLS

• Proficient in Microsoft suit


• Knowledge of Health Insurance Industry & Regulatory practices.


• Excellent communication skills


• Problem solving skills


• Strong ethical values


• Presentation Skills


• Emotional Intelligence