Branch Lead at Total Health Trust Ltd

Job Description

• To manage specific cases in the branch / zone in order to get the best outcome
• To facilitate the process of pre-authorisations and authorisations between the provider and the scheme and to give feedback to the relevant party concerned
• To facilitate resolution of all queries from providers and members within the branch/zone on specific cases and within the agreed SLA
• To facilitate the investigation of potential fraudulent claims within the specific branch / zone and provide feedback to the Branch manager
• Hospital visits regarding specific branch / zonal cases
• To provide services in the accreditation and re-accreditation of branch/zonal providers to ensure that provider facilities and services are up to standard as per the agreed standards using a standardized checklist.
• To adhere to and live the organizational values.

Qualifications

• Applicant must be a Registered Nurse
• Applicant must have 5-8 years experience
• Must have knowledge of NHIS
• HMO Experience is an added advantage

Other Requirements:

• Good communication skills
• Innovative and quick thinking capabilities
• Innovativeness
• Adaptive
• Decision Making skills
• Integrity
• Ability to work under pressure
• Adaptive, expertise, Result-Oriented, Relationship Skill
• Working with people
• Strategic