• Application Deadline: Tue, 22 Aug 2023 00:00:00 GMT
• Position: Care Coordinator/Provider Manager


• Job Type Full Time


• Qualification BA/BSc/HND


• Experience 2 - 4 years


• Location Abuja , Edo , Lagos , Niger , Rivers


• Job Field Medical / Healthcare 
  

RESPONSIBILITIES OF CARE COORDINATOR/PROVIDER MANAGER

• Inspection of healthcare facilities and accreditation of new facilities for onboarding and re-credentialing.


• Annual recertification/re-credentialing of all Providers.


• Annual collection of LONI certificates from all Providers.


• Provider relationship management and Provider Forums.


• Provider staff education – Provider induction at sign-on and ongoing education.


• Scheduling and carrying out quality assurance (QA) visits.


•  Assist with Pre-authorization of care based on the company’s pre-authorization guidelines and procedure.


• Investigating complaints from hospitals and responding to such correspondences.


• Investigating medical-related complaints from clients and responding to such correspondences.


• Health promotion (education, screening, etc.) and health benefit utilization education for clients.


• Concurrent and retrospective reviews of Enrollee feedback


• Providing approved billing guides and tariffs to hospitals


• Providing timely reports on Provider management


• Providing IHMS with feedback on Provider Relationship with IHMS


• Following up and getting feedback from Enrollees on admission Care


• Ensuring all correspondences with Providers are documented in email, reporting structure, survey or formal report as much as possible.

Note; HMO experience will be an added advantage

CARE COORDINATOR DUTIES

• Reach out to Patients on Admission


• Call or visit Patients during or at most one (1) week after admission


• Use the structured template to collect Patient reviews on Providers


• Provide feedback and utilization data


• Get feedback from Enrollees on treatment at various facilities


• Report on Enrollee utilization for each facility every year


• Reduce overbilling and over treatment


• Follow-up issues raised by the Claims Department to help Providers improve services