Medical Doctor (HMO) at Mediplan Healthcare

Responsibilities

• Develop and execute strategic plan to acquire and manage HMO providers in Mediplan Healthcare’s network
• Hospital assessment, accreditation and provider education
• Provide thorough assessment and credentialing of provider facilities
• Ensure prompt attention and resolution to provider issues
• Ensure effective case management/referral of enrollees on admission
• Organize and conduct annual medical examination for entitled clients
• Conduct tariff negotiations for provider services
• Monitor provider network to ensure quality assurance etc.

Qualifications

• A Degree in Medicine and Surgery (MBBS/MD).
• A valid practicing license with 2-5 years of post-accreditation experience, preferably within the Health Insurance/Managed Care environment
• Knowledge of the workings of the National Health Insurance Authority (NHIA) will be an added advantage.
• Strong interpersonal, communication, and leadership skills
• Excellent analytical and problem-solving skills
• Proficiency in Microsoft Office tools (Word, Excel,and PowerPoint).