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Tuesday 29 October 2013

Care Manager & Provider Relations Administrator needed at IAA HEALTHCARE EAST AFRICAN

 at IAA Healthcare and Resolution Health East Africa

Job Title: Care Manager & Provider Relations Administrator

Employer: IAA Healthcare and Resolution Health East Africa

Duty Station: Kampala, Uganda

Key Responsibilities:

Provider Relations

Undertake contracting of providers (hospitals and clinics)as per company protocols.
Administer the company’s accounts at providers.
Monitor and stock medical service providers with scheme documents and forms.
Manage processes to do with members’ direct access to specialists.
Conduct provider audits to ensure conformance with business requirements.
Undertake claims reconciliation with service providers and negotiate discounts.
Undertake provider training.

Care Management

Coordinate the integration of care management functions into patient care
Undertake pre-authorization and care management for scheme members for service access within and outside Uganda; Manage hospitalizations as per RIL care management protocol.
In liaison with the physician maintain an appropriate cost, case and desired patient outcome
Evaluate patient satisfaction and quality of care provided
Manage rescue and evacuations of members.
Assist members with chronic diseases on best practice disease management as per the RIL disease management protocol.
Maintain good relationships between providers and the company for the good of the scheme.
Coordinate International Emergency and Planned Admissions.
Undertake any third party recoveries as applicable.
Maintain all client pre-authorization records and hospitalization case notes records and provide weekly, quarterly & annual reports regarding care and provider operations as required.

Key Competencies:

Good oral and written communication skills
Exceptional commitment to customer service
Good analytical and problem solving skills organized, able to prioritize work

Skills and Knowledge:

Diploma in Nursing or Clinical Medicine
Diploma or degree in a business field
In-depth knowledge of care and health management


3 years’ experience in care management in a large modern hospital
Experience in a HMO/MIP an added advantage.
Accounting knowledge an added advantage
Knowledge of Microsoft Office with excellent skills in Excel
Proficiency in driving with a valid driving License
Outstanding communication skills – both verbal and written
organized, able to prioritize work
If you believe you are a team player and would be a valuable resource to this ever growing economy

How to Apply:

Email your application to: jobs@iaa-resolution.co.ug consisting of your application letter and updated CV listing three references, quoting the position in the email subject.
Only applications registered as per step 1 with a matching CV sent to us shall be considered
.Application Deadline: 7th Nov 2013

Only shortlisted candidates will be