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  • Posted: Jan 23, 2024
    Deadline: Not specified
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    IHMS is a national Health Maintenance Organization (HMO) established in 2001 to provide Social Health Insurance cover to individuals and groups under the National Health Insurance scheme and private health insurance services to interested individuals and groups. It is owned by medical practitioners and Institutional investors. We are accredited by the Nat...
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    Care coordinator

    We are seeking dedicated care coordinators for these regions; Abuja, Portharcourt, Minna, and Benin whose responsibility would be the following;

    RESPONSIBILITIES OF CARE COORDINATOR/PROVIDER MANAGER

    •  Inspection of healthcare facilities and accreditation of new facilities for onboarding and re-credentialing.
    •  Annual recertification/re-credentialing of all Providers.
    • Annual collection of LONI certificates from all Providers.
    • Provider relationship management and Provider Forums.
    • Provider staff education – Provider induction at sign-on and ongoing education.
    • Schedule and carry out quality assurance (QA) visits.
    • Assist with Pre-authorization of care based on the company’s pre-authorization guidelines and procedure.
    • Investigate complaints from hospitals and respond to such correspondences.
    •  Investigating medical-related complaints from clients and responding to such correspondences.
    • Health promotion (education, screening, etc.) and health benefit utilization education for clients.
    • Concurrent and retrospective reviews of Enrollee feedback
    • Providing approved billing guides and tariffs to hospitals
    • Providing timely reports on Provider management
    • Providing IHMS with feedback on Provider Relationship with IHMS
    • Following up and getting feedback from Enrollees on admission Care
    • Ensure all correspondences with providers are documented in email, reporting structure, survey, or formal report as much as possible.

    Only care coordinators from these regions; Abuja, Portharcourt, Minna, and Benin will be attended to.

    CARE COORDINATOR DUTIES

    • Reach out to Patients on Admission
    • Call or visit Patients during or at most one (1) week after admission
    • Use the structured template to collect Patient reviews on Providers
    • Provide feedback and utilization data
    • Get feedback from Enrollees on treatment at various facilities
    • Report on Enrollee utilization for each facility every year
    • Reduce overbilling and over-treatment
    • Follow-up issues raised by the Claims Department to help Providers improve services.

    Method of Application

    This job has expired or closed. Application is no longer allowed

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