Medical Manager at MetroHealth HMO Limited

Job Responsibilities:

• To verify and process for approval, all medical bills/claims of Enrollees from our Healthcare Providers.
• Carryout routine inspection of Healthcare provider’s facility within the network.
• Carryout registration and accreditation of Healthcare providers in the network.
• Process and authorization of referrals for our Enrollees to Healthcare providers.
• Providing expert advice on health promotions and disease prevention.
• Cooperate with the Executive team to initiate procedures, regulations and programmes  to benefit our patients and support our health centre in line with the best practice.
• Institute a behavioral framework for all healthcare providers at our clinical services locations.

Job Skills

• Critical thinking
• Problem solving skills
• Time Management and Excellent communication skills
• Teamwork skills
• Knowledge of Health Insurance will be an advantage
• Excellent written and verbal communication skills

Qualification Requirements:

• First Degree in Medicine from a recognized Institution.
• Applications will be accepted from physicians who are currently licensed.
• Experience:  3 years and above