Job Openings at Noor Health

Job Summary

The Internal Auditor is responsible for independently evaluating the adequacy and

• effectiveness of internal controls and compliance with policies, procedures, and regulations across all departments within Noor Health HMO. The role involves carrying out audit assignments that span operational, financial, and administrative areas to ensure transparency, efficiency, and adherence to applicable standards.
• The Internal Auditor provides evidence-based recommendations to improve processes and supports the Head of Internal Audit in promoting accountability and control discipline throughout the organization.

Key Responsibilities

Organization-wide Audit Execution

• Plan and execute comprehensive audits across all functional areas to assess
  operational effectiveness, policy compliance, and control adequacy.
• Review departmental processes for procedural consistency, accuracy of records,
  service delivery standards, and alignment with organizational goals.
• Audit claims processes to verify the authenticity of claims, compliance with policy terms, proper documentation, and alignment with benefit schedules.
• Conduct post-payment audits of healthcare providers to confirm services rendered, verify capitation and fee-for-service payments, and identify billing anomalies or potential abuse.
• Evaluate the control environment surrounding enrolee management, authorizations, and access to care across the provider network.

Regulatory and Internal Compliance

• Monitor compliance with NHIA regulations and other statutory requirements relevant to HMO operations.
• Audit NHIA filings, enrolee onboarding processes, premium management, and regulatory correspondences for accuracy and completeness.
• Identify and escalate compliance breaches, recommending corrective measures. Financial and Operational Reviews
• Review financial records, vendor payments, petty cash, payroll, and procurement processes for accuracy, transparency, and compliance with internal procedures.
• Verify documentation supporting financial transactions and ensure proper accounting treatment and approvals are in place.
• Conduct periodic asset and inventory audits to confirm existence, usage, and accountability.

Control Monitoring and Reporting

• Assess the design and effectiveness of internal controls across all departments and recommend practical improvements.
• Prepare clear, actionable audit reports with documented findings and proposed
  resolutions.
• Follow up on the implementation of agreed audit recommendations and provide
  status updates to the Head of Internal Audit.

Data Protection & Confidentiality

• Uphold the highest standards of confidentiality in handling company-related
  information, ensuring compliance with data protection laws and internal policies.
• Adhere to the company’s information security guidelines, including proper storage, transmission, and disposal of sensitive materials.
• Promptly report any suspected data breaches or unauthorized access to the
  appropriate company authority.
• Participate in periodic data protection training to stay informed about evolving
  security risks and best practices.

General Assignment

• Execute any other duties and tasks that may be designated or assigned by the
  Company.
• Participate in the knowledge sharing programme of the department and the
  company.
• To provide support to your manager, Managing Director, and Vice Chairman as may be required towards serving the Board, Management, and staff members.

Qualification

Education

• Bachelor’s degree in Accounting, Finance, Economics, or a related discipline. ACA, ACCA, or CIA certification is required.

Experience

• 5–7 years of relevant internal audit experience, with a minimum of 3 years in the Health Maintenance Organization (HMO) or health insurance industry.

Skills and Competencies

• Strong knowledge of internal audit practices and procedures.
• In-depth understanding of NHIA regulatory requirements and HMO
  operations.
• Excellent documentation, reporting, and analytical skills.
• Strong attention to detail and professional ethics.
• Proficient in the use of Microsoft Office and accounting/audit tools.
• Ability to work independently and deliver within timelines.

KPIs and Performance Metrics

• Completion rate of scheduled audit assignments (Target: ≥95% of audit plan).
• Timeliness and quality of audit reports (Target: within 10 working days post-audit).
• Implementation rate of audit recommendations (Target: ≥85%).
• Number of process improvement suggestions adopted.
• Incidence and resolution of audit-flagged issues

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Job Summary

• The Provider Relations Executive will assist in managing relationships between healthcare providers and the Health Maintenance Organization (HMO). This role involves supporting the onboarding process, coordinating communication between providers and HMO teams, addressing provider inquiries, and helping resolve issues related to claims, billing, or care delivery. The Provider Relations Executive will work closely with the Provider Relations Manager to ensure that providers are well informed and supported in their interactions with the HMO.

Responsibilities

Provider Communication & Support

• Serve as a point of contact for healthcare providers, answering inquiries and providing necessary support.
• Ensure providers are well-informed of HMO policies, procedures, and updates.
• Address and resolve issues raised by providers related to claims, billing, or service delivery.

Onboarding & Training

• Assist in the onboarding process for new providers, ensuring they are familiar with HMO guidelines.
• Help coordinate and deliver educational materials or training sessions for providers on relevant HMO policies and procedures.

Claims & Billing Assistance

• Provide support to providers in understanding and resolving claims and billing issues.
• Act as a liaison between the provider and claims department to ensure timely resolution of issues.

Performance Monitoring & Reporting

• Monitor provider performance and assist in the gathering of feedback from providers regarding their experience with the HMO.
• Prepare reports on provider performance and satisfaction for management review.

Data Protection & Confidentiality

• Uphold the highest standards of confidentiality in handling company-related information, ensuring compliance with data protection laws and internal policies.
• Adhere to the company’s information security guidelines, including proper storage, transmission, and disposal of sensitive materials.
• Promptly report any suspected data breaches or unauthorized access to the appropriate company authority.
• Participate in periodic data protection training to stay informed about evolving security risks and best practices.

General Assignment

• Execute any other duties and tasks that may be designated or assigned by the Company.
• Participate in the knowledge sharing programme of the department and the company
• To provide supports to the Managing Director and Vice Chairman as may be required towards serving the Board, Management and staff.

Qualification

Education

• Bachelor’s degree in Healthcare Administration, Business, or related field.

Experience

• Minimum of 2 years of experience in provider relations, healthcare administration, or customer service within an HMO environment.

Skills and Competencies

• Strong communication and interpersonal skills.
• Problem-solving abilities to handle provider issues effectively.
• Knowledge of healthcare billing and claims processes.
• Customer service-oriented mindset with a focus on provider satisfaction

KPIs and Performance Metrics

• Provider Support Efficiency: Timely resolution of provider inquiries and issues.
• Provider Satisfaction: Positive feedback from providers based on surveys and interactions.
• Claims Resolution: Percentage of claims and billing issues resolved to providers’ satisfaction.
• Onboarding Success: Successful completion of onboarding for new providers without delays.
• Performance Reporting Accuracy: Accuracy and timeliness of provider performance reports.

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Job Overview

The Care Coordinator is responsible for overseeing and coordinating the medical care of members to ensure appropriate, timely, and high-quality healthcare services in line with the HMO’s clinical guidelines and policies. The role involves clinical review, care planning, provider engagement, and medical decision-making to support effective utilization of healthcare services and positive member

• outcomes.
• The Care Coordinator works closely with healthcare providers, internal teams, and members to ensure continuity of care, proper clinical oversight, and adherence to approved benefits, while escalating complex medical issues to the Senior Medical Officer as required.

Key Responsibilities

Clinical Care Coordination

• Review and coordinate care for members requiring medical oversight, including admissions,
  referrals, and specialist care.
• Assess clinical information to determine medical necessity and appropriateness of proposed treatments.
• Support continuity of care by monitoring ongoing treatment plans and outcomes.
• Provide clinical guidance to members and providers in line with approved protocols.

Utilization Management & Clinical Review

• Conduct medical reviews for authorizations, admissions, procedures, and high-cost treatments.
• Ensure healthcare services align with benefit plans, clinical guidelines, and regulatory standards.
• Identify inappropriate utilization and recommend alternative, cost-effective care options where necessary.
• Escalate complex or high-risk cases to the Senior Medical Officer for further review

Provider Engagement & Member Support

• Liaise with hospitals, clinics, and specialists to facilitate effective service delivery to members.
• Clarify treatment plans, clinical decisions, and care pathways with providers as needed.
• Support Provider Relations by offering clinical input on quality-of-care issues and provider performance concerns.
• Serve as a clinical point of contact for members with complex medical needs.
• Support members in understanding their care plans, treatment options, and benefit coverage.

Documentation, Reporting & Quality Assurance

• Maintain accurate and complete medical records, care notes, and authorization decisions.
• Prepare clinical reports and summaries for internal review and management use.
• Ensure all clinical activities comply with NHIA regulations, company policies, and medical best practices.
• Participate in internal audits, clinical reviews, and quality improvement initiatives.

Data Protection & Confidentiality

• Uphold the highest standards of confidentiality in handling company-related information, ensuring compliance with data protection laws and internal policies.
• Adhere to the company’s information security guidelines, including proper storage, transmission, and disposal of sensitive materials.
• Promptly report any suspected data breaches or unauthorized access to the appropriate company authority.
• Participate in periodic data protection training to stay informed about evolving security risks and best practices.

General Assignment

• Execute any other duties and tasks that may be designated or assigned by the Company.
• Participate in the knowledge sharing programme of the department and the company
• To provide support to the Head of Information Technology as may be required towards serving the Board, Management, and staff.

Required Skills and Qualifications

Education

• Bachelor of Medicine, Bachelor of Surgery (MBBS or equivalent).
• Fully registered with the Medical and Dental Council of Nigeria (MDCN) with a valid practicing license.

Experience

• Minimum of 3–5 years’ post-qualification experience, preferably within an HMO, hospital, or managed care environment.

Skills & Competence

• Ability to assess medical necessity and determine appropriate treatment plans independently.
• Good understanding of managed healthcare and HMO operations
• Excellent communication and interpersonal skills
• Ensure accurate, thorough, and timely documentation of medical decisions and
  interactions.
• Interpret clinical data and identify trends, risks, and cost-effective care solutions.
• Build effective relationships with providers and internal departments; resolve
  conflicts professionally.

KPIs and Performance Metrics:

• Medical Review Accuracy: ≥ 98% of clinical authorizations and case reviews completed correctly, with minimal reversals or escalations.
• Follow-Up Timeliness: ≥ 95% of post-hospitalization or complex cases are followed up within the agreed timelines.
• Provider Engagement & Resolution: ≥ 90% of provider escalations addressed and resolved satisfactorily within SLA.
• Compliance & Documentation: 100% adherence to NHIA regulations, company policies, and complete, accurate clinical documentation.

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Job Overview

• The Retail Agent is responsible for generating sales of the health insurance products, including retail and corporate plans, by identifying potential clients, promoting the company’s offerings, and ensuring exceptional after-sales service.
• The role requires direct engagement with individuals, SMEs, and corporate organizations to understand their healthcare needs and recommend the most suitable solutions in line with the company’s portfolio.

Key Responsibilities

Sales & Marketing

• Actively promote and sell Noor Health Limited’s health insurance products, including retail and corporate plans, to individuals, SMEs, and corporate organizations.
• Conduct field visits, presentations, and promotional campaigns to attract potential clients.
• Engage in both face-to-face and digital marketing strategies to generate leads.
• Consistently achieve or exceed set monthly, quarterly, and annual sales targets.

Client Engagement & Retention

• Provide in-depth education to clients on plan features, benefits, and enrolment procedures.
• Build and maintain strong, long-term relationships to encourage renewals and referrals.
• Provide prompt and professional after-sales support to clients.
• Follow up regularly with clients to ensure satisfaction and identify upselling opportunities.

Compliance & Documentation

• Ensure accurate completion of proposal forms and other client documentation.
• Adhere to company policies, internal processes, and regulatory requirements.
• Safeguard all client information and maintain strict confidentiality.

Reporting & Market Intelligence

• Maintain an updated pipeline of leads, prospects, and client interactions.
• Submit timely and accurate daily, weekly, and monthly sales reports to the supervisor.
• Monitor and report competitor activities, pricing strategies, and market trends.
• Provide actionable feedback on customer needs, product gaps, and potential improvements.

Data Protection & Confidentiality

• Uphold the highest standards of confidentiality in handling company-related information, ensuring compliance with data protection laws and internal policies.
• Adhere to the company’s information security guidelines, including proper storage, transmission, and disposal of sensitive materials.
• Promptly report any suspected data breaches or unauthorized access to the appropriate company authority.
• Participate in periodic data protection training to stay informed about evolving security risks and best practices.

General Assignment

• Execute any other duties and tasks that may be designated or assigned by the Company.
• Participate in the knowledge sharing programme of the department and the company
• To provide support to your manager, Managing Director, and Vice Chairman as may be required towards serving the Board, Management, and staff members.

Required Skills and Qualifications

Education:

• Minimum of HND or OND/NCE in Marketing, Business Administration, or a related field (Bachelor’s degree is an advantage).

Experience:

• Minimum of 2 years’ proven sales experience, preferably in insurance, HMO, banking, or FMCG sectors.
• Proven track record of achieving sales targets.

Skills and Competence:

• Exceptional communication, negotiation, and networking skills.
• Strong presentation and persuasive selling abilities.
• Self-driven with the ability to work independently and manage time effectively.
• Basic proficiency in Microsoft Office and CRM tools.
• High ethical standards and a genuine customer-first mindset.

KPIs and Performance Metrics:

• Achievement of monthly, quarterly, and annual sales quotas.
• Client acquisition and retention rates.
• Accuracy and timeliness of documentation.
• Quality of customer relationships and satisfaction ratings.
• Volume and value of referrals generated.

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Job Summary

• The Business Development Executive is responsible for supporting the growth strategy of the Health Maintenance Organization (HMO) by identifying new business opportunities, acquiring clients, and maintaining strong relationships with enrollees and corporate partners.
• The role involves promoting the HMO's health plans, conducting market research, and achieving sales targets. The Officer will support the Head of Business Development in executing strategic initiatives and expanding the HMO’s market presence.

Responsibilities

Business Development & Sales Execution

• Identify and pursue new business opportunities for the HMO across corporate and retail segments.
• Promote and sell health insurance plans to individuals, SMEs, and large organizations.
• Assist in developing sales presentations, proposals, and customized health plan packages.

Client Engagement & Relationship Management

• Build and maintain strong relationships with existing clients, ensuring excellent service delivery.
• Engage with prospective clients to understand their healthcare needs and propose appropriate HMO plans.
• Handle client onboarding and follow-up to ensure satisfaction and plan utilization.

Market Research & Reporting

• Conduct competitor analysis and market research to support product positioning.
• Monitor industry trends and regulatory changes affecting the HMO sector.
• Prepare and submit regular reports on sales performance, market feedback, and client trends.

Collaboration & Support

• Work closely with the underwriting, provider relations, and customer service teams to ensure seamless service delivery.
• Collaborate with brand marketing to plan campaigns and develop promotional materials.
• Support the Head of Business Development in executing growth strategies and maintaining key accounts.

Data Protection & Confidentiality

• Uphold the highest standards of confidentiality in handling company-related information, ensuring compliance with data protection laws and internal policies.
• Adhere to the company’s information security guidelines, including proper storage, transmission, and disposal of sensitive materials.
• Promptly report any suspected data breaches or unauthorized access to the appropriate company authority.
• Participate in periodic data protection training to stay informed about evolving security risks and best practices.

General Assignment

• Execute any other duties and tasks that may be designated or assigned by the Company.
• Participate in the knowledge sharing programme of the department and the company
• To provide supports to the Managing Director and Vice Chairman as may be required towards serving the Board, Management and staff.

Qualification

Education

• Bachelor’s degree in Business Administration, Marketing, or a related field.

Experience

• Minimum of 3–4 years of experience in sales, marketing, or business development, preferably in a healthcare or HMO setting.

Skills and Competencies

• Excellent communication, negotiation, and relationship management skills.
• Good understanding of the health insurance industry and HMO operations.
• Ability to present complex information in a clear, client-focused manner.
• Proficient in Microsoft Office tools.
• Self-driven, result-oriented, and team player.

KPIs and Performance Metrics

• Client Acquisition Rate: Number of new individuals or organizations enrolled in HMO plans.
• Sales Target Achievement: Revenue generated from new business versus target.
• Client Retention Rate: Renewal and satisfaction of existing clients.
• Market Expansion: Penetration into new sectors, industries, or regions.

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Job Summary

• The Business Development Executive is responsible for supporting the growth strategy of the Health Maintenance Organization (HMO) by identifying new business opportunities, acquiring clients, and maintaining strong relationships with enrollees and corporate partners.
• The role involves promoting the HMO's health plans, conducting market research, and achieving sales targets. The Officer will support the Head of Business Development in executing strategic initiatives and expanding the HMO’s market presence.

Responsibilities

Business Development & Sales Execution

• Identify and pursue new business opportunities for the HMO across corporate and retail segments.
• Promote and sell health insurance plans to individuals, SMEs, and large organizations.
• Assist in developing sales presentations, proposals, and customized health plan packages.

Client Engagement & Relationship Management

• Build and maintain strong relationships with existing clients, ensuring excellent service delivery.
• Engage with prospective clients to understand their healthcare needs and propose appropriate HMO plans.
• Handle client onboarding and follow-up to ensure satisfaction and plan utilization.

Market Research & Reporting

• Conduct competitor analysis and market research to support product positioning.
• Monitor industry trends and regulatory changes affecting the HMO sector.
• Prepare and submit regular reports on sales performance, market feedback, and client trends.

Collaboration & Support

• Work closely with the underwriting, provider relations, and customer service teams to ensure seamless service delivery.
• Collaborate with brand marketing to plan campaigns and develop promotional materials.
• Support the Head of Business Development in executing growth strategies and maintaining key accounts.

Data Protection & Confidentiality

• Uphold the highest standards of confidentiality in handling company-related information, ensuring compliance with data protection laws and internal policies.
• Adhere to the company’s information security guidelines, including proper storage, transmission, and disposal of sensitive materials.
• Promptly report any suspected data breaches or unauthorized access to the appropriate company authority.
• Participate in periodic data protection training to stay informed about evolving security risks and best practices.

General Assignment

• Execute any other duties and tasks that may be designated or assigned by the Company.
• Participate in the knowledge sharing programme of the department and the company
• To provide supports to the Managing Director and Vice Chairman as may be required towards serving the Board, Management and staff.

Qualification

Education

• Bachelor’s degree in Business Administration, Marketing, or a related field.

Experience

• Minimum of 3–4 years of experience in sales, marketing, or business development, preferably in a healthcare or HMO setting.

Skills and Competencies

• Excellent communication, negotiation, and relationship management skills.
• Good understanding of the health insurance industry and HMO operations.
• Ability to present complex information in a clear, client-focused manner.
• Proficient in Microsoft Office tools.
• Self-driven, result-oriented, and team player.

KPIs and Performance Metrics

• Client Acquisition Rate: Number of new individuals or organizations enrolled in HMO plans.
• Sales Target Achievement: Revenue generated from new business versus target.
• Client Retention Rate: Renewal and satisfaction of existing clients.
• Market Expansion: Penetration into new sectors, industries, or regions.

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Job Summary

• The Medical Coding Executive plays a critical role in ensuring the accurate translation of medical services into standard codes for claims processing and clinical data reporting.
• This position supports the organization’s operational integrity by applying internationally accepted coding systems (such as ICD-10, CPT, and HCPCS) to medical records and claims, facilitating prompt and accurate reimbursement and compliance with regulatory standards.

Responsibilities

Medical Coding and Documentation

• Assist in reviewing medical tariff codes (e.g. ICD-10, CPT) under supervision.
• Support the team in ensuring accuracy and compliance with coding guidelines and HMO policies.
• Work with healthcare providers and internal teams to clarify basic documentation and coding issues.
• Continuously learn medical terminology, coding standards, and industry requirements.

Reporting and Compliance

• Help prepare simple reports and summaries related to coding and claims activities.
• Ensure assigned tasks comply with NHIS and other regulatory guidelines.
• Support internal reviews and audits as required.

Collaboration and Communication

• Work with different teams such as Provider Relations, Underwriting, and Medical Review.
• Support awareness by sharing basic coding knowledge with colleagues when required.
• Attend training sessions and learning programmes to build professional skills.

Data Protection & Confidentiality

• Uphold the highest standards of confidentiality in handling company-related information, ensuring compliance with data protection laws and internal policies.
• Adhere to the company’s information security guidelines, including proper storage, transmission, and disposal of sensitive materials.
• Promptly report any suspected data breaches or unauthorized access to the appropriate company authority.
• Participate in periodic data protection training to stay informed about evolving security risks and best practices.

General Assignment

• Execute any other duties and tasks that may be designated or assigned by the Company.
• Participate in the knowledge sharing programme of the department and the
  company
• To provide supports to your manager, Managing Director and Vice Chairman as may be required towards serving the Board, Management and staff.

Qualification

Education

• Bachelor’s degree in Health Information Management, Nursing, Medical Sciences, or related field.

Experience

• 0–1 year of experience in medical coding within an HMO, hospital, or health insurance setting. (NYSC or internship experience is an added advantage).

Skills and Competencies

• Basic understanding of medical terminology (or willingness to learn).
• Strong attention to detail and accuracy.
• Good analytical and problem-solving skills.
• Effective communication skills (written and verbal).
• Ability to learn quickly and adapt in a fast-paced environment.
• Good interpersonal skills and ability to work in a team.
• High level of integrity and professionalism.
• Familiarity with HMO claims workflows and healthcare regulatory guidelines.
• Detail-oriented with strong analytical and problem-solving skills.
• Ability to work both independently and collaboratively within a team environment.

KPIs and Performance Metrics

• Coding Accuracy Improvement – Progress in coding accuracy over time.
• Learning & Certification Progress – Completion of required training and certifications.
• Task Turnaround Time – Timeliness in completing assigned tasks.
• Error Identification Rate – Ability to detect and escalate errors.
• Team Collaboration Score – Feedback from supervisors and team members.

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Job Summary

• The Claims Executive is responsible for reviewing, processing, and validating medical claims submitted by healthcare providers to ensure accuracy, compliance, and adherence to the organization’s policies. The role involves working closely with hospitals and internal teams to ensure timely claims settlement while preventing errors and fraudulent claims.
• The Claims Executive also supports the Claims Supervisor in maintaining efficient claims operations and ensuring excellent service delivery to both providers and clients.

Responsibilities

Claims Processing & Verification

• Review and process medical claims from healthcare providers, ensuring accuracy and completeness.
• Verify enrollee eligibility, benefits, and coverage limits before approving claims.
• Identify discrepancies, errors, or fraudulent activities in submitted claims and escalate for review where necessary.
• Work closely with the underwriting, provider relations, and finance teams to ensure prompt claims settlement.
• Ensure timely processing of claims within established turnaround timelines.

Provider & Enrollee Engagement

• Liaise with healthcare providers to clarify claim-related issues and obtain missing information.
• Resolve enrollee complaints regarding denied, delayed, or partially approved claims.
• Build and maintain strong relationships with providers to ensure smooth claims management.

Compliance & Documentation

• Ensure claims are processed in line with NHIA (National Health Insurance Authority) guidelines, company policies, and regulatory standards.
• Maintain accurate and up-to-date claims records, ensuring proper documentation and filing.
• Support internal and external audits by providing required claims data and reports.

Continuous Process Improvement

• Identify gaps and inefficiencies in the claims process and recommend improvements.
• Support initiatives aimed at reducing claims turnaround time and enhancing customer experience.

Data Protection & Confidentiality

• Uphold the highest standards of confidentiality in handling company-related information, ensuring compliance with data protection laws and internal policies.
• Adhere to the company’s information security guidelines, including proper storage, transmission, and disposal of sensitive materials.
• Promptly report any suspected data breaches or unauthorized access to the appropriate company authority.
• Participate in periodic data protection training to stay informed about evolving security risks and best practices.

General Assignment

• Execute any other duties and tasks that may be designated or assigned by the Company.
• Participate in the knowledge sharing programme of the department and the company
• To provide supports to the Managing Director and Vice Chairman as may be required towards serving the Board, Management and staff.

Qualification

Education

• Bachelor’s degree in Insurance, Business Administration, Health Sciences, or a related field

Experience

• Minimum 2–4 years of experience in claims processing, health insurance operations, or related roles.

Skills and Competencies

• Good understanding of health insurance claims processes and NHIA regulations.
• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal abilities.
• High attention to detail with accuracy in data processing.
• Proficiency in Microsoft Office tools and claims management systems.
• Ability to work effectively in a fast-paced, team-oriented environment.

KPIs and Performance Metrics

• Claims Turnaround Time (TAT): Average processing time per claim.
• Accuracy Rate: Percentage of error-free claims processed.
• Provider & Enrollee Satisfaction: Resolution rate of provider and enrollee issues.
• Compliance Score: Adherence to NHIA regulations and internal claims policies.
• Claims Reconciliation Accuracy: Variance between processed claims and finance settlement records.

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Job Summary

• The Provider Relations Manager is responsible for managing the relationships between the Health Maintenance Organization (HMO) and its network of healthcare providers. This includes negotiating contracts, ensuring adherence to service level agreements (SLAs), and addressing provider concerns.
• The Provider Relations Manager will also oversee the onboarding process for new
• providers, ensure providers are educated on HMO policies, and support ongoing collaboration to ensure the delivery of high-quality care to enrollees.
• The role requires strategic oversight of provider engagement, ensuring both the HMO and the providers are aligned on goals and expectations.

Responsibilities

Provider Network Management

• Manage and oversee the network of healthcare providers, ensuring that they meet HMO standards and expectations.
• Lead the negotiation of contracts with healthcare providers, ensuring competitive and sustainable agreements.
• Continuously assess provider performance, addressing any issues with service delivery, billing, or quality of care.

Provider Onboarding & Education

• Coordinate the onboarding process for new healthcare providers into the HMO network.
• Educate providers on HMO policies, procedures, billing processes, and regulatory requirements.
• Develop training programs to ensure providers understand their roles and the expectations of working with the HMO.

Issue Resolution & Support

• Act as the primary point of contact for healthcare providers, addressing any concerns or issues they may have.
• Resolve disputes between providers and the HMO efficiently and effectively.
• Monitor provider satisfaction and implement improvements based on feedback.

Strategic Provider Development

• Develop and implement strategies to strengthen and expand the provider network.
• Identify opportunities for collaboration with providers to improve care delivery and reduce costs.
• Work closely with the business development team to expand provider offerings in new regions or service areas.

Data Protection & Confidentiality

• Uphold the highest standards of confidentiality in handling company-related information, ensuring compliance with data protection laws and internal policies.
• Adhere to the company’s information security guidelines, including proper storage, transmission, and disposal of sensitive materials.
• Promptly report any suspected data breaches or unauthorized access to the appropriate company authority.
• Participate in periodic data protection training to stay informed about evolving security risks and best practices.

General Assignment

• Execute any other duties and tasks that may be designated or assigned by the Company.
• Participate in the knowledge sharing programme of the department and the company.
• To provide supports to the Managing Director and Vice Chairman as may be required towards serving the Board, Management and staff.

Qualification

Education

• Bachelor’s degree in Healthcare Management, Business Administration, or related field.

Experience

• Minimum of 5 years of experience in provider relations or network management, with at least 2 years in a supervisory role.

Skills and Competencies

• Strong negotiation skills and the ability to manage multiple provider contracts.
• Excellent interpersonal and communication skills for building relationships with providers.
• Knowledge of healthcare regulations and HMO policies.
• Analytical skills to assess provider performance and make data-driven decisions.

KPIs and Performance Metrics

• Provider Engagement: Positive feedback from healthcare providers regarding communication and support.
• Network Expansion: Growth in the number of providers in the HMO network.
• Contract Negotiation Success: Percentage of successfully negotiated provider contracts.
• Provider Satisfaction: Improvement in provider satisfaction scores from surveys.
• Service Level Agreement (SLA) Compliance: Percentage of providers meeting HMO SLAs for care delivery.

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Job Summary

• The Branch Manager will oversee the operations of the branch office, ensuring seamless delivery of HMO services. The Branch Manager will serve as the primary point of contact for both members and healthcare providers within the region. This role also includes the responsibility for business development, managing relationships with local healthcare providers, and ensuring that the branch meets its financial and operational goals. The Branch Manager will work closely with the head office to align branch operations with corporate objectives, ensuring high standards of service delivery to enrollees.

Responsibilities

Branch Operations Management

• Oversee day-to-day operations of the Kaduna branch, ensuring smooth delivery of HMO services to enrollees and providers.
• Ensure compliance with HMO policies, procedures, and regulatory standards in all branch operations.
• Supervise branch staff, including enrollment officers, claims officers, and customer service teams, to ensure high performance and operational efficiency.

Business Development & Provider Relations

• Actively develop new business opportunities, including engaging with local employers to offer HMO membership to their employees.
• Manage relationships with local healthcare providers, ensuring effective contract management and service delivery.
• Lead efforts to expand the branch’s provider network by negotiating with hospitals, clinics, and healthcare professionals in the Kano region.

Customer Service & Member Engagement

• Ensure that enrollee concerns are addressed promptly and efficiently, with a focus on member satisfaction.
• Develop and implement strategies to increase member retention and engagement within the Kano branch.
• Handle escalated member complaints and resolve issues to their satisfaction, maintaining strong relationships.

Data Protection & Confidentiality

• Uphold the highest standards of confidentiality in handling company-related information, ensuring compliance with data protection laws and internal policies.
• Adhere to the company’s information security guidelines, including proper storage, transmission, and disposal of sensitive materials.
• Promptly report any suspected data breaches or unauthorized access to the appropriate company authority.
• Participate in periodic data protection training to stay informed about evolving security risks and best practices.

General Assignment

• Execute any other duties and tasks that may be designated or assigned by the Company.
• Participate in the knowledge sharing programme of the department and the company
• To provide supports to the Managing Director and Vice Chairman as may be required towards serving the Board, Management and staff.

Qualification

Education

• Bachelor’s degree in Healthcare Management, Business Administration, or related field.

Experience

• Minimum of 5 years of experience in healthcare or HMO management, with at least 2 years in a leadership role.
• Certification in healthcare management or business administration is a plus.

Skills and Competencies

• Strong leadership and management skills, with the ability to manage multi disciplinary teams.
• Excellent communication and relationship-building abilities, especially within the local healthcare and business communities.
• Knowledge of the HMO model, including insurance claims, provider networks, and healthcare service delivery.

KPIs and Performance Metrics

• Branch Growth: Increase in membership and provider network expansion in the Kaduna region.
• Service Delivery Efficiency: Improvement in service delivery times (e.g., claims processing, member inquiries).
• Provider Satisfaction: Positive feedback from local healthcare providers regarding collaboration and communication.
• Customer Satisfaction: Improvement in enrollee satisfaction and retention rates in the Kaduna region.