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  • Posted: Jan 13, 2016
    Deadline: Jan 26, 2016
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    Box & Cedar is an HR Consulting Firm. We believe in the power of people and exploiting it to the maximum because we know that people are the greatest assets of any organisation. We have distilled our products into what we call the 3S- Sourcing, Sieving and Stimulating. Our Vision To be the benchmark for quality and value in the Human Resource cons...
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    Health Maintenance Officer

    Job Description:

    • Ensure provision of excellent customer service.
    • To ensure waste reduction at all operating service point. This includes waste of time and resources
    • Ensures accurate registration process for new and existing clients
    • Co-ordinates Scheduling of  appointments according to established procedures
    • Ensures  reminder calls are made to clients in respect of their appointments
    • Ensures continuous training programs that will adequately develop and equip staff to function efficiently and provide necessary support in area of Health Maintenance Organizations.
    • Analyzing statistics or other data to determine the level of customer service the hospital is providing most especially as it concerns HMO’s.
    • Handling customer complaints or any major incidents, investigating and solving customers' problems and referring as appropriate when need be.
    • Liaison officer between the HMO’s and NHIS on issues related to the enrollees
    • Liaison officer between the HMO’s and the hospital on issues related to the enrollees
    • Ensure that fee for service bills are sent out to the HMO, Retainers as at when due.
    • Ensure that only identified enrollees’ access care.
    • Ensure that treatment coverage is limited to the guidelines
    • Ensure that only well-defined referral qualifies enrollees to access care. All ambiguous referrals must be disqualified.
    • Ensures that referrals emanating from the hospital requesting for secondary management are sent out as and when due.
    • Ensures that referral approvals with details of the extent of care approved are communicated as appropriate to the necessary unit to provide such care.
    • Ensure that Doctors and other members of the healthcare team are well informed on the guidelines of managed healthcare and operate within its bounds.
    • Monitor prescriptions for investigations and drugs of MHC patients and prepares statistical analysis of these to serve as an audit tool in ensuring prescribers understand the operations of the scheme.
    • Ensures that doctors limit secondary care management to what is approved.
    • Ensures that approvals are in line with the guidelines.
    • Monitoring and ensuring payment of capitation when due.
    • Liaises with corporate relations and accounts units to ensure that clients that have exceeded their credit limits are barred from accessing care.
    • Ensure all patients on admission meet up with the admission requirement as indicated in the company’s agreement.
    • Ensure referrals are raised and approval is gotten for all managed healthcare secondary care cases on admission
    • Ensure that the Hospital software is at time working and collate reports for Management

    Minimum Qualification:

    • A first degree

    Knowledge & Skills:

    •         Must have a scientific aptitude and detail oriented
    •         Be able to get and analyze information
    •         Ability to make good decisions and solve medical related issues
    •         Strong communication skills
    •         Expert in  Judging the Qualities of Things, Services, or People
    •         Multi-Tasking and Prioritizing
    •         Good organizational and Managerial skills 
    •         Up-to-date with current issues in the medical field
    •         Excellent Interpersonal Skills
    •         Be able to work under pressure and meet tight deadlines
    •         Assisting and caring for others

    Job Type:
    Full Time

    Experience:
    Minimum of 2 years

    Method of Application

    Interested in this position? Apply on Box and Cedar's Career Website

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