Latest Vacancies at Stresert Services Limited

Referencce Number: QAM-UTH

Duties and Responsibilities

• Work closely and coordinate the official activities of the Heads of Call Centre Unit, Claims Management Unit, the Underwriting Unit and the Providers Network Administration Unit for synergy and performance evaluation on a regular basis.
• Embark on systematic relationship management process with the key officers in all the HCFs that are enlisted as service providers by the organization in order to achieve cordial working relationship and the provision of quality services to enrollees at all times.
• In collaboration with the management, develop and deploy standard key performance indicators tools to regularly measure the day-to-day official responsibilities of all staff and also jointly develop and deploy monitoring and evaluation tools to generally address the issue of KPIs in the organization.
• The candidate is expected to anchor interactive sessions at the top-level and give health talks as approved by the management.
• The candidate is expected to interface with health care providers to resolve knotty professional-related issues that bother on the provision of qualitative health care services and enrollees’ satisfaction.
• Coordinate and oversee the maintenance of good record keeping both online and physically to ensure easy retrieval of information at all times.

Education:

• Applicants must possess a Medical Degree (MBBS) from a reputable tertiary institution
• Possession of MBA certificate will be required and serve as added advantage
• Possession of other relevant certificates in business management and or other areas of administration will be required and serve as added advantage.
• Up-to-date registration and license from the MDCN

Experience:

• Applicant must have minimum of 10 years Post NYSC experience.
• Minimum of 5 years’ experience working in a similar capacity.

Required Skills

Preference for the right candidate for this vacant position is the possession of abundant soft skills which include integrity, tenacity, strong determination to achieve measurable output, flexibility, innovative mind, respect for time keeping, teachable and a good personality overall.

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Reference Number QAN-ABJ-25

Job Summary

Our client is an HMO with offices across the six geopolitical zones in the country.

Duties and Responsibilities

• Attend to and resolve all enrollees’ enquiries and ensure that all complaints are promptly resolved on first call resolution, or immediately escalated to the appropriate group or unit.
• Meticulously log all for management analysis and documentation for all relevant stakeholders.
• Follow-up on specific cases as assigned by the line manager for measurable outcomes and stakeholders’ satisfaction.
• Actively and proactively engage in the vetting of bills from the organization’s network of facilities providing secondary/tertiary healthcare services on the public sector social health insurance program
• Benchmark all received claims with the pre-authorized codes given by call center as any service provided by any facility without pre-authorized code is considered null and void.
• Review all the received bills and possibly contact the enrollees for authorization of services provided.
• Investigate and report any incident of abuse, neglect or maltreatment of enrollees immediately to the Management for appropriate actions to be taken.
• Follow up on enrollees on admission in order to evaluate and document their progress and possibly assist the care team with developing and accessing health interventions.
• Participate in case management through scheduled and unscheduled visitation to enrollees on admission.

Education:

• Graduate Professional Nurse and First Degree from an accredited Baccalaureate Nursing Program (University)
• Must be a registered and licensed practitioner.
• Possession of recognized additional training in primary health care and midwifery is desirable.

Experience:

• Applicants must have minimum of 2 years’ experience as a Nurse and Midwifery Professional.
• Ability to work seamlessly with Computer and other communication equipment and software.