VP, Case Management and Care Coordination at Reliance HMO

The Role

Responsibilities:

• Data-driven analysis of enrollee feedback to understand trends
• Develop and execute a structured process to investigate claims associated with mortality, morbidity, fraud, waste, and abuse
• Managing full time and freelance case management staff to carry out investigations and maintain significant on-ground presence in facilities on our network to ensure compliance with care standards 
• Develop and execute structured standards for inclusion or exclusion of medical providers on Reliance Health’s network
• Develop and execute policies and procedures to support enrollees and quantifiably improve outcomes for those requiring emergency or prolonged care and those experiencing critical illness 
• Develop policies and practices to improve safety for enrollees seeking care within our provider network
• Develop policies and practices to improve medical quality within our provider network
• Own key performance indicators around provider quality feedback from stakeholders and reduction of claims paid for low-value, dangerous or negligent care

Ideal Profile

Skills Required:

• Minimum of Bachelor of Medicine and Bachelor of Surgery (MBBS), Bachelor of Dental Surgery (BDS)
• Minimum 5 years of clinical experience caring for patients
• Minimum 2 years of proven experience leading and managing of team of more than 3 people
• Additional training or experience in medical quality improvement and/or population health, data analysis skillsets is required
• Excellent analytical, problem solving, communication, data analysis and numeracy skills are a must have for this role
• Highly organized, detail-oriented, self-directed, and goal-driven with strong leadership and managerial skills 
• Strong crisis management and relationship management skills
• Must be physically present in Lagos
• Willingness to travel when required

What's on Offer?

• Leadership Role
• Fantastic work culture
• Join a well known brand within Healthcare