Wellness & Medical Examinations Coordinator at Equity Group Foundation

Description
 
Equity Afia (EQA) was established in 2015 under the umbrella of the Equity Group Foundation in response to the growing need for affordable and accessible quality healthcare for Kenyans.

The Equity Afia clinic network has over 54 medical centres in 19 counties across the country operated in a franchise model. The facilities are run by qualified and experienced doctors who are alumni of the Equity Leaders Program to offer affordable, high quality integrated & standardized health services.

The Wellness & Medical Examinations Coordinator will coordinate Wellness programs and Medical examinations for the Equity Afia medical centres, as well as care management.

They shall be responsible for:

• Developing wellness programs and customise wellness programs based on clients needs.
• Coordinating wellness health screenings, physical exams, and other diagnostic tests for patients at Equity Afia medical centres
• Coordinating health education/ health promotion for our clients on topics related to wellness such as stress management, nutrition, smoking cessation, exercise, healthy lifestyle changes, among others.
• Managing employee health plans on behalf of our clients to ensure that they meet all regulatory requirements
• Coordinating medical examinations at Equity Afia medical centers as recommended by insurance and corporates for life and medical covers
• Vetting and confirming validity of the service given by the service provider (Equity Afia) in relation to the benefits covered, treatment given, adherence to payer/insurance panel rules and cost of treatment.
• Obtaining additional required information on claims from providers, brokers, or clients, seeking medical clarifications including medical reports, copies of investigation reports, etc.
• Liaising with insurance providers on scope of cover for various schemes
• Assisting in conducting provider (Equity Afia medical centres) audits whenever necessary.
• Liaise with the insurance claims assessor(s) for outpatient claims from Equity Afia medical centres and coordinating on any information required to validate the claims.
• Interacting with clients, brokers, payers, and clinicians as needed, to resolve problems in a manner that is legal, ethical, and consistent with the principles and policies of Equity Afia
• Identify & leverage on opportunities for continuous quality improvement and process reengineering to optimize operational efficiency and patient care at the Equity Afia facilities
• Key Deliverables for this position
• Support in business acquisition and renewal with corporates/insurance providers
• Delivering well administered Wellness/Medical examination programs for our clients
• Liaison for Equity Afia and insurance companies/ corporate clients, performing care management functions to ensure accurate and timely dissemination of information to insurances companies/ corporate clients

Qualifications

• Diploma in Clinical Studies (Nursing/Clinical Medicine/Nutrition/Physiotherapy/Public health) or any other health related studies
• Course in Wellness/Health Education/Health promotion/ will be an added advantage.
• Minimum of 5 years’ relevant experience in a similar role.
• Basic Understanding of the Concepts of Insurance.
• Proficient in the use of Microsoft Office Suite and Packages.
• Excellent interpersonal skills
• Possess the ability to build personal relationships with key business stakeholders and have distinguished hands-on operational skills