Care Officer – Medical at CIC Insurance

PURPOSE:

Responsible for accurate capture of inpatient undertakings, authorization, cost control and hospital length of stay management.

PRIMARY RESPONSIBILITIES:

• Monitor inpatient authorizations and admission undertakings;
• Monitor cost control, average length of stay on inpatient authorizations;
• Pre-authorize optical and scheduled cases;
• Coordinate medical care monthly Rota and duty allocation and ensure conformity to rota and assigned duties/coverage;
• Respond to client, provider and contact person queries on cases involving medical care management;
• Receive and respond to Medical emergency lines and ensure 24-hour coverage and
• Negotiate for discounts from doctors on specific cases and procedures as they arise.

 GENERIC DUTIES

• Carry out performance appraisal, coaching and mentoring staff;
• Participate in planning and budgeting for the department.

PERSON SPECIFICATIONS

Academic Qualifications

• Bachelor’s degree in Health System Management, Nursing or in a related field

Professional Qualifications

• COP-Insurance is an added advantage

Experience

• Up to three (3) years’ relevant experience

Skills and Attributes

• Problem solving skills;
• Good analytical skills;
• Computer literate in MS Office and other office applications;
• Understanding of the working environment /competitors;
• Technical competence in insurance;
• Basic knowledge of regulations by AKI and IRA;
• High emotional intelligence;