Health Care Manager Job Opportunity – People Performance Group (PPG)

Organisation: People
Performance Group (PPG)
Duty
Station:
 Kampala, Uganda
Reports to: Employee
Benefits Manager and Chief Operations Officer
About
US:
The People Performance Group (PPG) is a Human Resource (HR) consultancy
firm which is highly committed to the provision of expert advice in
Recruitment, Search and Selection, Team Building, Training, HR systems and
Outsourcing of Staff since 2005.
Our client a brocker in
the insurance industry.
Key Duties and Responsibilities: 
·        
Review
and audit claims documents from the Service providers and clients, credit
facility reports for the TPA schemes, account replenishment status and handle
all related issues to eliminate/ avoid delays in claims settlement.
·        
Responsible
for Service provider accreditation and issuance of appointment letters to
service providers as a prerequisite for joining the service provider panel of
our TPA schemes.
·        
Provide
scheme care management that includes patient hospital visits, client
utilization, technical/clinical advice to clients, call Centre management and
issuance of patient’s admissions preauthorization letter/instructions.
·        
Supervise
the day to day claims management for the Medical Department including internal
review and Analysis of all Client medical utilisation reports and data prior to
dispatch to the clients.
·        
Provide
the highest standard of service on a day to day basis. All queries should be
handled promptly and ensure there are no complaints from clients, medical
service providers, insurers, and medical department team.
·        
Assist
the medical team in respect of the proposals/initiatives and
implementation/rollout of the client’s employee wellness/wellbeing programs or
any Health & safety initiatives. Ensure that risk management/wellbeing
initiatives/insurance programmes are properly geared to address the client’s
exposure.
·        
Ensure
timeliness of work processing, including claim settlement to clients and
Service providers.
·        
Accompany
the Employee Benefits Manager/ Handlers on visits to clients (incl
sensitization meetings, health talks etc.) and visits to Insurers as may be
requested.
·        
Tasked
with the issuance of monthly Health Nuggets to our clients vide email. Responsible
for the dissemination of any other health related information to clients.
·        
Responsible
for the sales and Business Development of the Wellness Services/solutions
including monitoring of the client wellness programs to ensure they are fully
implemented.
·        
Responsible
for the development of Capitation models for our clients for the management of
their onsite clinics/medical facilities. You will also be in charge of the
supervision/monitoring of the capitation contract to ensure that the
deliverables are achieved or implemented. Regular reports should be submitted
to track performance of the capitation contract.
·        
Supervise
the claims team and ensure that the claims team fully complies with the claim
processes as per the Operations manual/procedures. Also ensure that
claims/utilization reports as requested by medical department team or client
are submitted timeously.
·        
Responsible
for Minet Limited Health Management System(HMS) and data base including the
SMART system and data base. Ensure management of systems and data bases as per
guidelines including integrity & security of the data and maintaining
confidentiality of all medical/healthcare information in the system.
·        
Monitor
and report on local and international markets, Insurance products, market
developments and Insurer activities.
·        
Handle
the client’s portfolio in accordance with the Minimum Standards set in the
Minet Limited Medical/healthcare operations procedures/manual and the Service
Level Agreement with the client. A copy of the agreement must be obtained from
the Employee Benefits Manager.
·        
Provide
relevant reports and information to the executive as may be requested.
·        
Manage
relationships with Service providers/Insurers in conjunction with Employee
Benefits Manager and ensure full adherence to the SLA between Minet Limited and
Service providers/Insurer and ensure all service deliverables are achieved.
Quality Assurance for the Insurers and Service providers on the Minet Provider
panel is included under this role.
·        
Provide
new ideas for improving the Company business e.g. ideas on efficiency,
productivity, profitability, competition and ideas to obtain new business.
·        
Support
the Minet Limited staff who may have healthcare issues/challenges including
first Aid treatment and OHS related interventions.
·        
Attend/
participate in the Medical Insurance and Healthcare Forums/ Associations in
Uganda.
·        
Any
other roles as may be allocated by your Supervisor.


Qualifications, Skills and Experience: 
·        
The
applicant must possess adequate medical knowledge /qualification (nurse/doctor/clinical
knowledge)
·        
A
minimum of five years of experience in relevant field
·        
Leadership
skills
·        
Experience
in handling hospitals
·        
Computer
knowledge
·        
Good
Communication skills
·        
Interpersonal
skills
How to Apply:
All candidates are
encouraged to send their applications as soon as possible to
application@ppg.co.ug. E-mails that exceed 2MB will not be considered.
Deadline: 20th July 2018
NB:
While we thank all applicants for your interest, only those selected for
interviews will be contacted.
For more of the
latest jobs, please visit 
http://www.theugandanjobline.com or find us on our facebook page https://www.facebook.com/UgandanJobline




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