Job Title: Care Manager & Provider Relations Administrator
Organization: IAA-Resolution Health East Africa Limited
Location: Kampala, Uganda
Deadline: 7th November, 2013
About Us:
IAA-Resolution, which is a partnership between IAA Healthcare and Resolution Health East Africa, offers healthcare packages that provide our clients with high value in benefits and unique service. IAA- Resolution has a strong accredited medical service provider network of over 500 hospitals, clinics and doctors all across East Africa.
Job Summary:
The Care Manager & Provider Relations Administrator will be primarily interface with medical service providers and acquire the best service provision arrangements for our members.
Key Duties and Responsibilities:
1. 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.
2. 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.
Qualifications, Skills and Experience:
The applicant should possess a Diploma in Nursing or Clinical Medicine and / or Diploma or degree in a business field
Comprehensive knowledge of care and health management
Three 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
Good oral and written communication skills
Exceptional commitment to customer service
Good analytical and problem solving skills
Organized, able to prioritize work
Outstanding communication skills – both verbal and written
Exceptional commitment to customer service
Good analytical and problem solving skills
How to Apply:
If you believe you are a team player and would be a valuable resource to this ever growing brand, please:
Click here to register your application
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.
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