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THT helps make healthcare work in Nigeria. We enable our customers to access affordable, reliable healthcare and we support healthcare providers in their efforts to deliver it. We manage healthcare so that our customers and our partners can thrive. THT is one of Nigeria’s pioneer Health Management Organisations (HMOs), renowned by our stakeholders f...
Job Description:
• To conduct hospital visit, inspection, accreditation, re-accreditation, education, claims audit, fraud detection, clinical audit, investigation of member’s related queries, resolve issues of short-payments as the need arise
• Implement provider management strategies for organizational growth, competitiveness and leadership
• To reconcile provider account received from the geographical regions assigned as well as any other delegated by the team lead.
• Organize and carry-out product, policies and processes training in-house for group of providers in assigned geographical areas.
• To negotiate with doctors and other health care providers about health care for clients
• Liaison with NHIS
• Represent organization in the health care events
• Update providers register under schemes and share updates with concerned departments
• Provide detailed provider management report
• Ensure that all critical areas that require improvement that contribute to the success of the strategy are identified and communicated to the team lead.
• Ensure prompt registration and processing of providers’ contracts on Medware.
Requirements:
• Candidate must be a registered nurse, midwife and possess B.Sc. Nursing
• Additional medical qualification will be an added advantage
• Candidate must have minimum of 5 years post-nursing qualification experience including 3 years in similar role in a Health Maintenance Organization (HMO).
• Candidate must have Clinical experience
• Candidate must have advanced knowledge of NHIS regulatory guidelines, Medical Global Best Practices, Health Insurance, Products and Processes.
• Excellent organizational, communication (verbal and written) skills and attention to detail
Other requirements:
• Good organizational and planning capabilities
• Innovative and quick thinking capabilities
• Innovativeness
• Adaptive
• Decision Making skills
• Integrity
• Negotiation Skill
• Adaptive, expertise, Result-Oriented, Relationship Skill
• Working with people
• Strategic
• Must be a good collaborator/Team player
Job Description:
• To take responsibility of the health services department.
• To supervise, monitor and discharge daily inspection upon staff with the view to ensure the set goals of efficiency and effectiveness in the discharge of health insurance project.
• To effectively manage the relationship with providers
• To manage the process of hospital inspection, accreditation and re-accreditation
• To formulate and implement provider management strategies for organizational growth, competitiveness and leadership
• To ensure quality assurance with all Health Care Providers across the country
• To negotiate with Doctors and other health care providers about health care for clients
• Liaison with NHIS
• Represent organization in the health care events
• Provision of assessments and treatments for members of staff
• Hospital inspection/accreditation
• Supervise fraud investigation process
• Follow-up on complaints of staffs and providers.
• Payment Reconciliation
• To manage Providers training and provide advisory services.
Requirements:
• Candidate must be a Medical Doctor.
• Additional medical qualification will be an added advantage
• Candidate must have minimum of 10 years Health Maintenance Organization (HMO) experience.
• Candidate must have minimum of 5 years Clinical experience
• Candidate must have advanced knowledge of NHIS regulatory guidelines, Medical Global Best Practices, Health Insurance, Products and Processes.
• Excellent organizational, communication (verbal and written) skills and attention to detail.
Other requirements:
• Good organizational and planning capabilities
• Innovative and quick thinking capabilities
• Innovativeness
• Analytical Skills
• Decision Making skills
• Leadership Skill
• Integrity and Transparent honesty
• Negotiation Skill
• Adaptive, expertise, Result-Oriented, Relationship Skill
• Working with people
• Strategic
• Must be a good collaborator/Team player
To apply for this position, visit Total Health Trust Limited Career Page
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