PURPOSE:
Responsible for care facilitation/cost containment and call centre reachability.
PRIMARY RESPONSIBILITIES:
- Issuance of approval to insured members seeking both inpatient and outpatient care as per policy
- Monitor cost, average length of stay on inpatient
- Issue guidance on Pre-authorized optical, dental and scheduled procedures
- Conduct Hospital visits whenever the insured members are hospitalized
- Respond to stakeholder inquiries on cases involving medical care
- Receive and respond to Medical emergency lines and ensure 24-hour coverage
- Negotiate for discounts from doctors and hospitals on specific cases and procedures from time to time
- Facilitate referrals and medical evacuations when need
- Monitor benefits utilization and share timely updates to the
- Prepare and share timely reports as may be guided.
| Key Skills, Knowledge, Experience and Behavioral Competencies | |||||||||||||||||||||||||
These are defined as; Academic and Professional Requirements
Experience Required: |
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| Description | Required years of experience | Need Type | |||||||||||||||||||||||
| Relevant experience in Care Management, medical claims and call centre | 2 | E | ||||||||||||||||
| Behavioral Competencies
These are defined as:
|
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| Core Competencies | Proficiency Required | |||||||||||||||||
| 1. Customer Focus | B | |||||||||||||||||
| 2. Business Acumen | B | |||||||||||||||||
| 3. Driving Innovation | B | |||||||||||||||||
| 4. Driving Business Performance | B | |||||||||||||||||
| 5. Negotiation and Influence | B | |||||||||||||||||
| 6. Effective Communication | B | |||||||||||||||||
| Leadership Competency | Proficiency Required | |||||||||||||||||
| 1. Planning and organizing | B | |||||||||||||||||
| 2. Accountability | B | |||||||||||||||||
| 3. Quality Decision Making | B | |||||||||||||||||
| 4. Building Partnerships | B | |||||||||||||||||
| 5. Continuous Learning | B | |||||||||||||||||
| 6. Emotional Intelligence | B | |||||||||||||||||
| 7. Conflict Management | B | |||||||||||||||||
| Special Position Requirements ( Optional section: any travel, security, hazard or related special conditions which apply to the position) | ||||||||||||||||||
| · The role holder may be required to travel to distant branches or wherever the Company has any interest.
· Role holder may be required to work extended working hours to ensure jobs are completed on schedule and to specification. |
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If you have the aforementioned professional and academic qualifications and you are ready to execute the above mandate, strictly apply through: https://careers.cicinsurancegroup.com/ clearly indicating the position being applied for.
The application should reach us by close of business on 7th November, 2024. Please note only short-listed candidates will be contacted. If you do not hear from us by 30th November, 2024 consider your application unsuccessful.
N/B: This job advert is open to both internal and external candidates.