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  • Posted: Feb 9, 2021
    Deadline: Not specified
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    Old Mutual Kenya is based in Nairobi and is part of a larger group that offers solutions in long-term savings, asset management and investment. We offer solutions to individuals and corporates underpinned by our core values which are: Respect, Integrity, Accountability and Pushing beyond boundaries.
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    Case Management Nurse

    Your time is now to be your exceptional best at Old Mutual!

    Job Description

    KEY TASKS & RESPONSIBILITIES

    • Pre-authorize scheduled and emergency admissions within the defined guidelines.
    • Determine the appropriate parameters for admission i.e. initial authorized cost and expected length of stay
    • Negotiate professional fees as appropriate for each admission.
    • Conduct hospital visits for admitted clients within the major towns
    • Liaise with doctors on the day to day management of patients and obtain medical reports where indicated.
    • Ensure smooth discharge process and coordinate any necessary post-hospitalization or stepdown care.
    • Revise reserves after discharge of member.
    • Collect feedback from admitted clients on quality and level of service by the providers
    • Assist in verification and audit of inpatient claims prior to settlement
    • Maintain relevant reports on admissions
    • Promptly respond to queries from clients, intermediaries and providers
    • Liaise with underwriting section for development of new products or benefits
    • Proactively escalate any identified risks or risk events
    • Any other duty assigned by management

    Skills & Competencies

    • Excellent communication and negotiation skills.
    • Excellent interpersonal relationship skills.
    • Extensive networking with SP and other medical insurers.
    • Excellent analytical and monitoring skills
    • Good decision making in benefit utilization management.
    • High level of integrity and honesty

    Qualifications, Knowledge & Experience

    • Diploma/Bachelor in Nursing or Clinical Medicine
    • Any insurance certification e.g. COP is an added advantage
    • At least 2 years’ relevant experience within a health insurance
    • At least 2 years’ experience in a busy hospital setting

    Responsibilities

    Skills and Experience

    Method of Application

    Interested and qualified? Go to Old Mutual Kenya on oldmutual.wd3.myworkdayjobs.com to apply
  • Send your application

    Back To Home View All Vacancies at Old Mutual Kenya
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Average Salary at Old Mutual Kenya
KSh 137K from 3 employees
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