Jobs at Revolutionary Health Maintenance Organization (RevoHealth)

Role Purpose

• The Finance Officer is a critical mid-level role responsible for the financial integrity and regulatory alignment of the HMO. The position balances traditional corporate accounting with the specialized financial demands of the healthcare industry.

Core Strategic Pillars:

• Financial Operations & Reporting: Managing the full accounting cycle, including monthly financial statements, budgetary oversight, and bank reconciliations to ensure organizational liquidity.
• Healthcare Value Chain Management: Direct oversight of Capitation and Fee-for-Service (FFS) payments. This involves close collaboration with medical audit teams to ensure claim authenticity and adherence to Service Level Agreements (SLAs).
• Revenue Assurance: Tracking and reconciling premium collections from corporate and individual enrollees to maintain a healthy cash flow.
• Regulatory & Statutory Compliance: Ensuring strict adherence to NHIA financial guidelines and the timely remittance of statutory taxes (VAT, WHT, and PAYE).
• Data-Driven Analysis: Monitoring the Medical Loss Ratio (MLR) and identifying cost-saving opportunities within the clinical value chain to protect profit margins.

Candidate Profile

• Credentials: A degree in Accounting or Finance, ideally supported by professional certification (e.g., ICAN, ACCA).
• Experience: 3 – 5 years in a structured finance environment, with a strong preference for candidates from the insurance or healthcare sectors.
• Technical Skillset: Advanced proficiency in financial modelling (Excel) and enterprise accounting software (e.g., Sage or SAP).

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Role Purpose

• Manage, control and ensure that company accounting activities and procedures conform to generally accepted accounting principles.

Key Responsibilities

• Develop and implement the company’s financial strategy in alignment with overall business objectives
• Manage financial planning, budgeting, and forecasting.
• Develop financial policies that ensure compliance and integrity.
• Monitor cash flow, accounts, and payroll
• Prepare transparent, insightful financial reports for stakeholders.

Person Specification

• Education and Skills: Bachelor’s Degree in Finance, Accounting, or related fields
• Proficient in financial reporting, budgeting, and accounting software
• Experience: 8+ years in finance, preferably in healthcare or HMO.
• Qualities: Ethical, analytical, detail-oriented, with a strategic perspective.

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Position Overview

• Provides strategic leadership for IT infrastructure, operations, cybersecurity, and enterprise systems.
• Ensures alignment of IT services with RevoHealth business objectives.

Key Responsibilities

• Develop and implement IT strategy and governance framework.
• Oversee infrastructure, networks, cloud, and enterprise systems.
• Ensure cybersecurity, data protection, and compliance.
• Manage IT budgets, vendors, and SLAs.
• Lead disaster recovery and business continuity planning.
• Support ERP, HMO systems, and enterprise integrations.

Qualifications

• Bachelor’s Degree in Information Technology, Computer Science, or a related field
• Certifications: PMP, ITIL highly preferred.

Key Skills & Competencies:

• Strong leadership and IT governance expertise.
• Experience with cloud, cybersecurity, and enterprise systems.
• Strategic planning and vendor management skills.

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Requirements

• Candidates must possess a Doctorate (Ph.D) Degree in Business Administration with 12 years of teaching / research experience or an academic Master's Degree with minimum of 15 years of  teaching / research experience.
• Publications in at least 4 reputable, peer-reviewed journals as well as membership or relevant professional bodies with demonstrable administrative and leadership qualities are advantages.

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Description

• The Claims Management Officer manages the end-to-end claims process, ensuring timely, accurate, and fraud-free claims settlement while optimising cost efficiency and enhancing customer satisfaction.
• They are accountable for claims cost efficiency and control, accuracy and integrity of claims payments, fraud prevention and detection, customer experience in claims handling, provider payment discipline and compliance, and alignment with underwriting assumptions (loss ratio control).

Responsibilities
This role focuses on:

• Overseeing end-to-end claims processing and adjudication
• Ensure timely and accurate claims settlement
• Implement cost control and utilisation management
• Detect and prevent fraud and abuse
• Manage provider relations and billing integrity
• Handle complaints and claims disputes
• Ensure compliance with NHIA and internal policies.

Required Qualifications and Experience

• Bachelor’s Degree in Medicine, Nursing, Pharmacy, Insurance, or related field (preferred)
• Professional certification in healthcare management, insurance, or risk (preferred)
• Minimum 4 years experience in claims management or healthcare operations
• Strong knowledge of NHIA guidelines, provider tariffs, and healthcare systems
• Experience in claims adjudication, fraud management, and utilization review.

Key Competencies:

• Claims Adjudication Expertise – Deep understanding of medical claims processes
• Analytical Skills – Ability to detect anomalies and fraud patterns
• Cost Management – Strong focus on cost containment strategies
• Attention to Detail – Accuracy in claims review
• Regulatory Knowledge – Understanding of NHIA and healthcare compliance
• Problem-Solving – Ability to resolve disputes effectively
• Stakeholder Management – Strong engagement with providers and customers.

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Summary Job description
Note 1

• To manage enrollee relationships by ensuring seamless healthcare access, handling enquiries and complaints, and supporting registration processes to drive high client satisfaction, loyalty, and to guarantee optimal client satisfaction and retention
• Manage enrollee inquiries and support by serving as the primary point of contact for assigned enrollees while providing personalized guidance on utilizing their health plans effectively.
• Engage clients and improve retention.
• Build trust and rapport with enrollees through regular check-ins and tailored support.
• Coordinate access to healthcare services and ensuring enrollees do not face delays at hospitals by coordinating with the medical team.
• Handle complaints and escalations
• Act as a bridge between the enrollee, the hospital and internal departments to clear operational bottlenecks
• Maintain accurate records by keeping detailed and updated profiles of enrollee interactions, claims history, and feedback within the central database
• Propose actionable process improvements to management
• Ensure seamless service delivery across enrollee touchpoints
• Identify opportunities for service improvement

Requirements

• Education: B.Sc / HND Social Science or Health-related course preferred
• Experience: 2–3 years experience in HMO operations, enrolee management or customer service role.

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Responsibilities

• The Head of Client Services is responsible for designing, implementing, and managing client service strategies to ensure exceptional customer experience across all touchpoints. The role oversees call center operations, client engagement, service delivery standards, and continuous improvement initiatives
• Design and implement strategies to enhance customer satisfaction and experience across all service channels.
• Drive continuous improvement in Net Promoter Score (NPS) performance trends
• Manage end-to-end Call Center activities across inbound, outbound, and digital channels.
• Develop and enforce SLAs covering response times, resolution times, and call quality while tracking KPIs such as Average Handling Time (AHT), First Call Resolution (FCR), and Call Abandonment Rate.
• Establish and manage an effective complaint resolution framework.
• Handle escalations and resolve complex client issues promptlyDevelop and enforce SOPs for client service and call center operations
• Standardize procedures across teams to ensure consistency in service delivery
• Provide reports and insights on client service performance
• Lead, mentor, and manage the client services and call center teams.
• Set performance goals and conduct regular appraisals.
• Ensure seamless service delivery across enrollee touchpoints

Education

• Bachelor’s degree and MBA in Business Administration or related field
• Certified Customer Experience Professional (CCXP) or a related certification

Experience

• 7+ years experience in Client Service management with proven experience in Call Center operations