Job Openings 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

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MetroHealth HMO Ltd is seeking to engage a highly competent and experienced Finance Executive to join our dynamic team.

Job Requirements

• Bachelor’s Degree in Accounting
• Minimum of 2–4 years relevant experience in the HMO/Health Insurance industry (mandatory)
• Proficiency in the use of Sage Accounting Software
• Strong knowledge of financial reporting, reconciliation, budgeting, and compliance processes
• Professional accounting certification (Institute of Chartered Accountants of Nigeria qualification is an added advantage)
• Excellent analytical and problem-solving skills
• Strong attention to detail and ability to work under pressure

Key Responsibilities

• Prepare and maintain accurate financial records and reports
• Manage reconciliations and financial transactions
• Monitor claims and provider payment processes
• Ensure regulatory and statutory compliance
• Support budgeting, forecasting, and financial planning activities
• Utilize Sage for financial data management and reporting

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MetroHealth HMO Ltd is seeking a qualified and dedicated Call Centre Executive (Registered Nurse) to join our team.

Job Requirements

• Must be a Registered Nurse (RN) with valid professional certification
• Bachelor’s Degree or Diploma in Nursing
• Relevant experience in healthcare service delivery or HMO operations is an added advantage
• Strong communication and customer service skills
• Ability to handle patient/provider inquiries professionally
• Good knowledge of healthcare processes and medical terminology
• Strong problem-solving and multitasking abilities
• Proficiency in computer applications

Key Responsibilities

• Attend to enrollees’ inquiries and complaints professionally
• Provide accurate information on healthcare benefits and authorization processes
• Liaise with healthcare providers and members to resolve issues promptly
• Escalate medical and operational concerns where necessary
• Maintain accurate records of calls and service requests
• Deliver excellent customer support in line with company standards

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MetroHealth HMO Ltd is seeking a qualified and experienced Claims Executive to join our dynamic team.

Job Summary

The Claims Executive will be responsible for claims processing, vetting, analysis, reconciliation, and ensuring timely and accurate claims administration in line with organizational standards.

Requirements

• Must be a Registered Nurse (RN) with relevant professional certification
• Minimum of 3 years’ relevant experience in the HMO/Health Insurance space
• Strong knowledge of medical claims processing and tariff interpretation
• Good understanding of NHIA guidelines and healthcare claims management
• Excellent analytical and reconciliation skills
• High level of accuracy and attention to detail
• Proficiency in Microsoft Office and claims management systems
• Strong communication and interpersonal skills

Key Responsibilities

• Vet and process provider claims accurately and promptly
• Review claims for compliance with benefit plans and tariffs
• Liaise with healthcare providers on claims-related issues
• Conduct claims reconciliation and reporting
• Identify discrepancies and recommend corrective actions
• Ensure adherence to internal policies and regulatory requirements