PURPOSE:
Responsible for care facilitation/cost containment and call centre reachability.
PRIMARY RESPONSIBILITIES:
- Issuance of approval to insured members seeking both inpatient and outpatient care as per policy guidelines.
- Monitor cost, average length of stay on inpatient cases.
- Issue guidance on Pre-authorized optical, dental and scheduled procedures
- Conduct Hospital visits whenever the insured members are hospitalized
- Respond to stakeholder inquiries on cases involving medical care management.
- Receive and respond to Medical emergency lines and ensure 24-hour coverage
- Negotiate for discounts from doctors and hospitals on specific cases and procedures from time to time
- Facilitate referrals and medical evacuations when need be.
- Monitor benefits utilization and share timely updates to the stakeholders.
- Prepare and share timely reports as may be guided.
| Key Skills, Knowledge, Experience and Behavioural Competencies | ||||||||
Academic and Professional Requirements
Experience Required:
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| Special Position Requirements (Optional section: any travel, security, hazard or related special conditions which apply to the position) | ||||||||
| · The role holder may be required to travel to distant branches or wherever the Company has any interest. · Role holder may be required to work extended working hours to ensure jobs are completed on schedule and to specification. |
If you have the aforementioned professional and academic qualifications and you are ready to execute the above mandate, strictly apply through: https://careers.cicinsurancegroup.com/ clearly indicating the position being applied for.
N/B: This job advert is open to both internal and external candidates.
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