International Health Management Services Care Coordinator / Provider Manager Jobs in Nigeria

International Health Management Services Care Coordinator / Provider Manager Jobs in Nigeria




Responsibilities

  • 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.

    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

    Requirements

  • Possess relevant qualifications

  • HMO experience will be an added advantage




    How to Apply

    Interested and qualified candidates should send their Resume to: ihmsresponses@gmail.com using the Job Title as the subject of the email.

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