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CarePay is a Kenyan company that administers conditional healthcare payments between funders, patients and healthcare providers. Through our M-TIBA platform, CarePay directs funds from public and private funders directly to patients into a "health wallet” on their mobile phone. The use of these funds is restricted to conditional spending at selected he...
MAIN PURPOSE OF JOB:
The Case Manager’s overall purpose is to monitor, evaluate and coordinate medical benefit utilization to ensure quality, appropriate and cost effective care, as well as ensure business relationship with existing, new and potential Medical Service Providers (MSP) is as healthy as possible and that our clients are getting services as promised. The Case Manager will be expected to demonstrate commitment, loyalty and perform all duties in accordance with the CarePay’s office routines and procedures, keeping in mind the overall business objectives. In addition, the Case Manager will assess medical claims (including but not limited to outpatient services) submitted by MSPs and adjudicate such claims including necessary follow up with the MSP. Case Manager will develop and enhance our patient service codes, charges and packages as well as negotiate the best rates.
DUTIES AND RESPONSIBILITIES:
KEY PERFORMANCE MEASURES:
EDUCATIONAL QUALIFICATIONS, KNOWLEDGE & EXPERIENCE:
KEY SKILLS AND COMPETENCIES:
DECISION MAKING AUTHORITY
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