• Application Deadline:
• Position: Medical Manager



• Job Type Full Time



• Qualification BA/BSc/HND



• Experience 2 years



• Location Lagos




• Job Field Medical / Healthcare 
  
  

Responsibilities

• Oversee, identify, accredit, contract, train, and manage the primary care providers and medical specialists who provide services to the enrollees (members) on HMO’s health insurance and third-party administration plans.


• Develop, coordinate, implement, and evaluate case management services to health plan enrollees/members and health care providers that contract with the HMO.


• Collaborate with other staff in evaluating placement of members in proper primary care locations, developing, and adapting forms and information systems, and mediating difficult member and provider situations.


• Oversight of timely medical management, utilization management, and discharge management interventions to meet clinical targets, and assure the provision of a continuum of care to enrollees.


• Maintain and support the primary care provider and specialist network to the health plans by developing and managing training materials, leading small and large groups, on-site initial training sessions on the policies and procedures of the health plan, problem-solving sessions on managing members in the health plan, writing memorandums, letters regarding clarification of covered benefits or procedure changes.


• The medical manager will also research, evaluate, and respond to individual health care provider requests for exceptions to covered services or pharmaceutical benefits, and resolve urgent or complicated individual situations raised by providers.


• Oversee the Provider Services unit by developing and updating resource materials and comparison grids for easy reference, specifically tailored to each of the health plans.


• Assist in the development and implementation of a quality assurance and utilization review program. Develop new policies and procedures and enforce existing standards. Construct, evaluate, and revise forms in consultation with the Managing Director.


• Evaluates and compiles complaints from providers, members, or other Health Plan Management Team members to determine a pattern of complaints and initiate a resolution. Initiate further training sessions, better or more frequent phone or written communications, or reassess current policies to control problems.


• Performs other duties as assigned by the MD/CEO.

Requirements

• Candidates should possess an MBBS Degree (Required).


• 2+ years’ experience in an administrative role at a healthcare practice.


• Able to handle sensitive patient information with confidentiality.


• Excellent customer service skills.


• Professional and courteous in tone and information delivery.


• Strong organization and leadership skills.