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  • Posted: May 16, 2022
    Deadline: May 23, 2022
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    Jubilee Insurance was established in August 1937, as the first locally incorporated Insurance Company based in Mombasa in 1937. Jubilee Insurance has spread its sphere of influence throughout the region to become the largest Composite insurer in East Africa, handling Life, Pensions, general and Medical insurance.
    Read more about this company

     

    Care Manager

    Job Ref. No. JHIL030

    Role Purpose

    The role holder will be responsible for visiting patients at the various service providers, providing professional guidance on policy matters, ensuring comfort and assistance of patient by the service provider, and communicating with providers, clients and brokers on a timely basis for any rejections or relevant concerns

    Main Responsibilities

    • Obtaining daily reports of admissions in the various service providers
    • Broker/customer communications by communicating as necessary admission claim decisions on a timely basis
    • Care Management - Through due diligence, ensuring undertakings are issued in line with the policy provisions. Likewise for
    • declines, ensuring that the decisions are accurate
    • Fraud mitigation – Implementing fraud mitigation strategy for the company.
    • Provider relationship management – Ensuring strong provider relationships to enhance provider and customer experience.
    • Visiting of patients at the various service providers, obtaining details of patients to confirm that admitted members are the eligible policy holders/ dependents
    • Confirming that the treatment the member is given is covered by the policy purchased
    • Ensuring that the medical reports in the hospital are accurate and reflective of what is provided to the insurer and also confirm what the member understands or communicates
    • Ensuring proper care and treatment of patient within acceptable protocols without wastage by member/ provider
    • Reviewing medical pre-authorizations for compliance with applicable policy guidelines and giving guidance to the other care management team on any information collected during the visits to the hospitals

    Key Competencies

    • Passionate, Goal driven and results oriented.
    • Strong organizational and analytical skills.
    • Strong Problem-solving skills.
    • Communication skills
    • Team Spirit
    • Strong interpersonal & relations skills

    Qualifications

    • Degree/ Diploma holders preferably in clinical studies (nursing)
    • University Graduate in a relevant field will be an added advantage
    • Proficient in the use of Microsoft Office suite & packages (Word, Excel, PowerPoint and Vision)
    • Basic understanding of the concepts of insurance

    Relevant Experience

    • Minimum of 5-years relevant experience preferably in care management field.

    Method of Application

    If you are qualified and seeking an exciting new challenge, please apply via Recruitment@jubileekenya.com quoting the Job Reference Number and Position by 23rd May 2022. Only shortlisted candidates will be contacted.

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