Care Manager at MUA Kenya

JOB PURPOSE 

The role holder will coordinate and oversee the preauthorization process for inpatient and outpatient ensuring compliance with policy terms, quality healthcare delivery, timely decisions, and cost-effective outcomes for members.

Academic Background & Relevant Qualifications

• Diploma or Bachelor’s Degree in Nursing, Clinical Medicine, Pharmacy, or related medical field.
• Professional qualifications in insurance (e.g., COP, AIIK, CII) will be an added advantage.
• Registration and valid practicing license with a recognized professional body (e.g., Nursing Council of Kenya, Clinical Officers Council, Pharmacy and Poisons Board).
• 2–5 years of experience in clinical practice or health insurance claims management.
• Experience in preauthorization processes, cost containment, and provider negotiations.
• Familiarity with claims management systems and MS Office tools