Medical Manager at MetroHealth HMO Limited

MetroHealth HMO Ltd is seeking a highly experienced and competent Medical Manager to join our team.

Job Summary

The Medical Manager will oversee clinical operations, provider network management, claims adjudication oversight, case management, and ensure quality healthcare service delivery in line with regulatory and organizational standards.

Requirements

• Must be a qualified Medical Doctor (MBBS/MBChB) with a valid practicing license
• Minimum of 5 years’ relevant experience in the Health Maintenance Organization (HMO) space
• Strong knowledge of healthcare management, utilization review, and provider relationship management
• Sound understanding of NHIA regulations and healthcare quality standards
• Strong analytical, leadership, and decision-making skills
• Excellent communication and stakeholder management abilities
• Proficiency in healthcare data analysis and reporting

Key Responsibilities

• Oversee medical operations and clinical service delivery
• Manage provider network performance and relationships
• Review and authorize medical claims where necessary
• Ensure compliance with regulatory and internal clinical standards
• Drive quality assurance initiatives and cost-effective healthcare delivery
• Provide medical advisory support to management

Only candidates with proven HMO experience and who are qualified Medical Doctors will be considered