Clinical Control Officer at AfyA Care

JOB SUMMARY:

This role will involve supporting the clinical entities to implement an effective NMCH (Nursing and Midwifery Council of Nigeria), MDCN (The Medical and Dental Council of Nigeria) and FMH (Federal Ministry of Health) guidance and clinical control program. The post holder will be key to supporting regular control reviews of clinical entities. You will also be central to supporting service developments, best practices, and training/development initiatives as informed by learning from serious incidents/errors, in conjunction with clinical teams.

KEY RESPONSIBILITIES:

• Maintains and analyzes quality data, identifies trends, and recommends corrective actions.

• Coordinates medical regulation audit engagements and responds to complex inquiries.

• Prepares and submits material for external audits and Corrective Action Plans

• Facilitate compliance with the defined Standard Operating Procedures

• Work with medical staff to identify and resolve authorization load error report system problems

• Coordinate clinical directorate review outcomes with the established medical representative to identify, develop and publish corrective actions/educational material related to control or audit errors

• Coordinate clinical control review and communicate outcomes to designated Medical Specialists to resolve or enhance clinical systems

• Provide education to healthcare professionals regarding correct documentation and detailed recommendations to improve the organization’s procedures and policies

• Expected to identify fraudulent claims, outliers, reimbursement deficiencies, inefficiencies, incorrect codes and poor documentation to protect the organization’s revenue against bills challenged by health insurance companies

QUALIFICATION:

• First degree in Medical Sciences (Physiology, Pharmacology, Medical Biochemistry,
  Nursing, Medical Laboratory Science)

• 3 – 5 years’ experience in a hospital or diagnostics company.