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Care Officer – Medical
PURPOSE:
- Responsible for accurate capture of inpatient undertakings, authorization, cost control and hospital length of stay management.
PRIMARY RESPONSIBILITIES:
- Facilitating admissions and discharges of insured members as per policy.
- Conduct hospital visits
- Manage cost and average length of stay while the patients are in hospital to ensure prudent utilization.
- Pre-authorize treatment for outpatient/inpatient cases as per the policy guidelines
- Timely respond to all queries from insured client, service providers and respective contact person on cases involving medical care management.
- Maintain a good relationship with partners such as intermediaries at care management level.
- Update the relevant stakeholders on the case management update
- Coordination and facilitation of both road and air evacuation as per policy.
- Seamless Coordinating of overseas treatment from admission to discharge.
- Compile relevant reports within the scope of care management as per stipulated guidelines
- Receive and respond to Medical emergency lines on a 24-hour basis to ensure adequate coverage of the call Centre
- Negotiate for discounts from doctors and service providers on specific cases and procedures as they arise.
Academic and Professional Requirements
Education
- Bachelor’s degree in Nursing or clinical Medicine. E
- Computer literate in MS Office and other office applications E
- Medical Insurance experience in a medical call centre is an added advantage D
Experience Required:
- Relevant experience in busy health environment 3
REGIONAL TEAM LEADER – RETAIL LIFE – NAIROBI & CENTRAL (2 POSITIONS)
Responsibilities
- Recruitment, selection and retention of productive Sales Officers;
- Conducting trainings on company products, processes, sales and soft skills to achieve results;
- Building good relationship with the Relationship officers, Branch Managers and allied channel staff to achieve set sales targets;
- Performance management and supervision to drive retail life sales and meet targets;
- Provide one-to-one coaching, mentoring and motivation to Sales Officers and ensure that they effectively implement strategies and agreed action plans;
- Searching proactively for new revenue generating opportunities in the channel allocated to meet the company targets and following up on new leads and referrals;
- Providing effective customer service to both prospective and existing customers;
- Preparing sales and other management reports as required from time to time and proactively addressing shortfalls; and
- Performing any other duties as may be assigned by the Line Manager
Qualifications
- Minimum of a Diploma in a business related course. A Bachelor’s degree will be an added advantage
- Must have a valid IRA License for the current year
- Minimum 3 years’ relevant experience within the financial services industry
- Relevant professional qualifications in Certificate of Proficiency in Insurance – COP/ECOP/Diploma in Insurance (AIIK/CII) or LOMA
- Excellent leadership, communication and interpersonal skills
- Problem solving skills
- Understanding of the working environment