Job Openings at Green Field Health Management Limited

Job Description

• The deputy medical manager shall assist the Medical Manager in the running of the Health Services/Quality Assurance Department.
• He/She shall report to the Medical Manager.

Job Functions/Responsibilities

• Referral System and Pre-authorization
• Case Management
• Care Coordination
• Claims adjudication
• Quality Assurance
• Provider credentialing and profiling
• Provider Management
• Medical Auditing
• Statistical Analysis of medical losses, referrals, encounters, utilization of care, and provides evidence-based advice to the medical manager.

Requirements/Qualifications

• Must possess an MBBS and MPH
• Minimum of 7 years post-NYSC
• Minimum of 5 years of relevant HMO experience.
• Familiar with the use of statistical tools such as Stata, SPSS etc.

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Job Description

• He/she shall coordinate the health insurance operations of the company.
• He/she shall supervise the medical and the ICT departments and ensure that their activities are in sync with the general delivery of healthcare services.
• He/She shall be responsible for healthcare providers management, care coordination, case management, referral system, medical auditing, quality assurance, claims adjudication and providers reimbursement, contact center coordination, management of the HMO software ensuring always that its functionalities are yielding the expected results, coordinates end to end health insurance operations from the enrollment of beneficiaries to healthcare access and to providers reimbursement.
• He/She must coordinate all health insurance business processes in a seamless and efficient manner that guarantees the overall satisfaction of both enrollees and providers.

Requirements/Qualifications

• Must possess an MBBS and MPH or M.Sc in Health Economics, Policy, and Management.
• Professional membership of a relevant medical or insurance body.
• Must have a minimum of 10 years post-NYSC
• Must have relevant HMO experience of about 5-8 years.
• Familiar with the health insurance industry in Nigeria.