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IAA-Resolution Jobs – Care Manager & Provider Relations Administrator
Organization: IAA-Resolution
Health East Africa Limited
Health East Africa Limited
Duty Station: Kampala,
Uganda
Uganda
About Us:
IAA-Resolution, which is a partnership between IAA
Healthcare and Resolution Health East Africa, offers healthcare packages that
provide our clients with high value in benefits and unique service. IAA-
Resolution has a strong accredited medical service provider network of over 500
hospitals, clinics and doctors all across East Africa.
Healthcare and Resolution Health East Africa, offers healthcare packages that
provide our clients with high value in benefits and unique service. IAA-
Resolution has a strong accredited medical service provider network of over 500
hospitals, clinics and doctors all across East Africa.
Job Summary: The Care Manager & Provider Relations
Administrator will be primarily interface with medical service
providers and acquire the best service provision arrangements for our members.
Administrator will be primarily interface with medical service
providers and acquire the best service provision arrangements for our members.
Key Duties and Responsibilities:
1. Provider Relations:
- Undertake contracting of providers
(hospitals and clinics)as per company protocols. - Administer the company’s accounts at
providers. - Monitor and stock medical service providers
with scheme documents and forms. - Manage processes to do with members’
direct access to specialists. - Conduct provider audits to ensure
conformance with business requirements. - Undertake claims reconciliation with
service providers and negotiate discounts. - Undertake provider training.
2. Care Management:
- Coordinate the integration of care
management functions into patient care - Undertake pre-authorization and care
management for scheme members for service access within and outside
Uganda; - Manage hospitalizations as per RIL care
management protocol. - In liaison with the physician maintain an
appropriate cost, case and desired patient outcome - Evaluate patient satisfaction and quality
of care provided - Manage rescue and evacuations of members.
- Assist members with chronic diseases on
best practice disease management as per the RIL disease management
protocol. - Maintain good relationships between
providers and the company for the good of the scheme. - Coordinate International Emergency and
Planned Admissions. - Undertake any third party recoveries as
applicable. - Maintain all client pre-authorization
records and hospitalization case notes records and provide weekly,
quarterly & annual reports regarding care and provider operations as
required.
Qualifications, Skills and Experience:
- The applicant should
possess a Diploma in Nursing
or Clinical Medicine and / or Diploma or degree in a business field - Comprehensive
knowledge of care and health management - Three
years’ experience in care management in a large modern hospital - Experience
in a HMO/MIP an added advantage. - Accounting
knowledge an added advantage - Knowledge
of Microsoft Office with excellent skills in Excel - Proficiency
in driving with a valid driving License - Good
oral and written communication skills - Exceptional
commitment to customer service - Good
analytical and problem solving skills - Organized,
able to prioritize work - Outstanding
communication skills – both verbal and written - Exceptional
commitment to customer service - Good
analytical and problem solving skills
How to Apply:
If you believe you are a team
player and would be a valuable resource to this ever growing brand, please:
player and would be a valuable resource to this ever growing brand, please:
- Click here to register your application
- Email your application to jobs@iaa-resolution.co.ug consisting
of your application letter and updated CV listing three references,
quoting the position in the email subject.
Only applications registered as
per step 1 with a matching CV sent to us shall be considered.
per step 1 with a matching CV sent to us shall be considered.
Deadline: 7th November,
2013
2013
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