Care Manager at Imara Mediplus Medical Centre

JOB SUMMARY:

The Care manager is responsible for coordinating and facilitating patient care across various departments and services within the hospital. This role involves assessing patient needs, planning and managing care programs. and closely with healthcare professionals to optimize patient outcomes.

KEY RESPONSIBILITIES:

• Sending pre-authorizations of Scheduled and non- scheduled admissions within the set guidelines. •Follow-up on third party system delays.
• Following up on pre-approvals sent to insurers and notifying patient's on progress.
• Updating medical reports and progress reports to the insurer.
• Liaise with doctors on the day-to-day management of patients and obtain medical reports.
• Ensure smooth admission and discharge process of patients
• Daily reporting of pre-authorizations report shared to insurance companies.
• Any other duty as assigned by the supervisor in line with the job description

QUALIFICATIONS:

• Degree or Diploma in Kenya Registered Community nursing/Clinical medicine.
• Diploma in insurance.
• Minimum of three (3) years' experience in a clinical setting /busy health insurance environment with care Management.

JOB SKILLS:

• Excellent communication skills both written and spoken.
• Team Player.
• Excellent customer service skills
• Excellent public relations and interpersonal skills
• Good IT skills in database management and office systems.
• Excellent analytical and monitoring skills
• Extensive networking with SP and other medical insurers