Job Title: Relationship Manager – Transactional Banking Organisation: Bank of Africa…
Head of Claims, Case Management and Underwriting Job Vacancy – AAR Healthcare Uganda Limited
Organization: AAR Healthcare
Uganda Limited
Uganda Limited
Duty Station: Kampala,
Uganda
Uganda
About US:
AAR Healthcare Uganda Limited is the largest provider of outpatient
health care services in Uganda having begun its operations in 1994. The company
is committed to excellent client experience with a focus on quality provision
of health services, by engaging professionally qualified staff, continuous
review of its medical practice, systems and processes.
health care services in Uganda having begun its operations in 1994. The company
is committed to excellent client experience with a focus on quality provision
of health services, by engaging professionally qualified staff, continuous
review of its medical practice, systems and processes.
Job Summary: The Head of
Claims, Case Management and Underwriting will ensure delivery of appropriate,
consistently high quality, cost effective and curative clinical services to all
hospitalized AAR members through application of case management. The incumbent
will also ensure consistent management of provider relationships through
selective contracting and timely payment. The incumbent will ensure efficient
and accurate processing of medical claims in keeping with managed care
principles.
Claims, Case Management and Underwriting will ensure delivery of appropriate,
consistently high quality, cost effective and curative clinical services to all
hospitalized AAR members through application of case management. The incumbent
will also ensure consistent management of provider relationships through
selective contracting and timely payment. The incumbent will ensure efficient
and accurate processing of medical claims in keeping with managed care
principles.
Key Duties and
Responsibilities:
Responsibilities:
·
Responsible for hospitalization costs management
Responsible for hospitalization costs management
·
In charge of clinical risk management
In charge of clinical risk management
·
In charge of claims management
In charge of claims management
·
Responsible for provider relationship management
Responsible for provider relationship management
·
Tasked with provider account management
Tasked with provider account management
Key Result Areas:
·
Ensure prompt vetting of claims from date of
receipt within 1 day
Ensure prompt vetting of claims from date of
receipt within 1 day
·
Ensure timely submissions of claims from PPOs
referral centres, Health Care and hospitals
Ensure timely submissions of claims from PPOs
referral centres, Health Care and hospitals
·
100 lines of Hospitalization claims assessed in
8.5 hours
100 lines of Hospitalization claims assessed in
8.5 hours
·
200 lines of outpatient claims assessed in 8.5
hours
200 lines of outpatient claims assessed in 8.5
hours
·
Timely and accurate processing of claims based
on pre-determined standards
Timely and accurate processing of claims based
on pre-determined standards
·
Claims should be ready for payment not later
than 5 days from the date received.
Claims should be ready for payment not later
than 5 days from the date received.
·
Handling of client queries completely and
accurately first time round
Handling of client queries completely and
accurately first time round
·
Efficient and accurate problem solving
Efficient and accurate problem solving
·
Company knowledge 80%
Company knowledge 80%
·
Staff training
Staff training
·
Performance Management Evaluation at 100% for
staff who have been confirmed
Performance Management Evaluation at 100% for
staff who have been confirmed
·
Refund Administration.
Refund Administration.
Qualifications, Skills and
Experience:
Experience:
·
The applicant must have attended medical
training with a Medical Degree with relevant clinical experience plus
experience in management or a Master Degree with relevant experience managing
comparable units in non Government organizations.
The applicant must have attended medical
training with a Medical Degree with relevant clinical experience plus
experience in management or a Master Degree with relevant experience managing
comparable units in non Government organizations.
·
At least three years’ experience in medical
claims management and underwriting.
At least three years’ experience in medical
claims management and underwriting.
·
Proven Leadership skills, good interpersonal
skills, and ability to enhance corporate performance
Proven Leadership skills, good interpersonal
skills, and ability to enhance corporate performance
·
Excellent communication, negotiation, and
conflict resolution and administrative skills
Excellent communication, negotiation, and
conflict resolution and administrative skills
·
The applicant should have distinguished level of
maturity and excellence in muliti-disciplinary health care management.
The applicant should have distinguished level of
maturity and excellence in muliti-disciplinary health care management.
·
ICT Competency
ICT Competency
How to Apply:
All suitably qualified and interested candidates should send us their
comprehensive applications and up-to-date CVs, copies of certificates including
daytime telephone numbers via email to hr@aar-healthcare.com. Your application
should include three referees, none of whom should be your relative and all of
whom should have supervised you, taught you or known you through work. The
referees’ information should include day time telephone numbers and email
addresses. Please note that only successfully candidates will be contacted.
comprehensive applications and up-to-date CVs, copies of certificates including
daytime telephone numbers via email to hr@aar-healthcare.com. Your application
should include three referees, none of whom should be your relative and all of
whom should have supervised you, taught you or known you through work. The
referees’ information should include day time telephone numbers and email
addresses. Please note that only successfully candidates will be contacted.
Deadline: 16th
September 2016
September 2016
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