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  • Posted: Feb 11, 2021
    Deadline: Feb 23, 2021
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    Doheney Services Ltd is a Human Resource Consulting outfit set up in November 2004. The Firm is a one- stop firm providing specialized and in depth human resource consultancy services across several key industries. Some of the industries we cover include Oil & Gas, Telecommunications, Banking & Financial Services, Transport & Logistics, manufactu...
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    Officer 2, Provider Management (Medical Operations )

    Job title: Officer 2, Provider Management (Medical Operations )

    Industry: Healthcare

    Job Objective:

    Involves all the activities and procedures adopted by the HMO to ensure an effective and efficient oversight on the provider-enrollee relationship, build a mutually beneficial relationship with healthcare providers and ensure that the business remains profitable.

    Responsibilities:

    • Sign up of providers across the country
    • Provider selection and management: enlisting, negotiation, delisting, rewarding, training, enlightening
    • Tariff negotiation and review
    • International Providers selection and management
    • Scheduling major and highly specialized patient procedure
    • Utilization Review Management (total review of all enrollees that receive care within the period)
    • Case Management – concurrent and post-management review with managing physicians
    • Providers audit and quality assurance: this involves infrastructure audit, treatment protocol compliance, service quality
    • Care review for admitted and complex cases in a secondary and tertiary care
    • Review of care delivery protocols
    • Analysis of hospitals tiers and capability

    Requirements:

    • Bachelor of medicine, bachelor of surgery
    • Minimum 0 - 3 years total work experience
    • Knowledge of the function
    • Knowledge of the Business
    • Analysis and development of solutions
    • Decision-making autonomy

    Method of Application

    This job has expired. Application is no longer allowed

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