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
Experience:
• 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
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
Experience:
• 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
