Job Description:
Ensure provision of excellent customer service.
To ensure waste reduction at all operating service point. This includes waste of time and resources
Ensures accurate registration process for new and existing clients
Co-ordinates Scheduling of appointments according to established procedures
Ensures reminder calls are made to clients in respect of their appointments
Ensures continuous training programs that will adequately develop and equip staff to function efficiently and provide necessary support in area of Health Maintenance Organizations.
Analyzing statistics or other data to determine the level of customer service the hospital is providing most especially as it concerns HMO’s.
Handling customer complaints or any major incidents, investigating and solving customers’ problems and referring as appropriate when need be.
Liaison officer between the HMO’s and NHIS on issues related to the enrollees
Liaison officer between the HMO’s and the hospital on issues related to the enrollees
Ensure that fee for service bills are sent out to the HMO, Retainers as at when due.
Ensure that only identified enrollees’ access care.
Ensure that treatment coverage is limited to the guidelines
Ensure that only well-defined referral qualifies enrollees to access care. All ambiguous referrals must be disqualified.
Ensures that referrals emanating from the hospital requesting for secondary management are sent out as and when due.
Ensures that referral approvals with details of the extent of care approved are communicated as appropriate to the necessary unit to provide such care.
Ensure that Doctors and other members of the healthcare team are well informed on the guidelines of managed healthcare and operate within its bounds.
Monitor prescriptions for investigations and drugs of MHC patients and prepares statistical analysis of these to serve as an audit tool in ensuring prescribers understand the operations of the scheme.
Ensures that doctors limit secondary care management to what is approved.
Ensures that approvals are in line with the guidelines.
Monitoring and ensuring payment of capitation when due.
Liaises with corporate relations and accounts units to ensure that clients that have exceeded their credit limits are barred from accessing care.
Ensure all patients on admission meet up with the admission requirement as indicated in the company’s agreement.
Ensure referrals are raised and approval is gotten for all managed healthcare secondary care cases on admission
Ensure that the Hospital software is at time working and collate reports for Management
Minimum Qualification:
A first degree
Knowledge & Skills:
Must have a scientific aptitude and detail oriented
Be able to get and analyze information
Ability to make good decisions and solve medical related issues
Strong communication skills
Expert in Judging the Qualities of Things, Services, or People
Multi-Tasking and Prioritizing
Good organizational and Managerial skills
Up-to-date with current issues in the medical field
Excellent Interpersonal Skills
Be able to work under pressure and meet tight deadlines
Assisting and caring for others
Job Type: Full TimeExperience: Minimum of 2 years
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