Job verified by Fuzu

Jubilee Insurance KE   |   Eldoret, Kenya   |   Log in or register to see the closing date

Care Manager - Field

  • Bachelor's degree
  • Medical, health
  • Manager (team leader)
  • Full Time
  • Permanent
Click to apply

Job Summary

Job Ref. No. HRJIC424

We currently have an exciting career opportunity for the position of Care Manager - Field, Medical Department.


Role Purpose
The job holder will be accountable for Care Management which includes visiting patients at the various service providers, providing professional guidance on policy matters where requested, ensuring comfort and assistance of patient by the service provider, and communicating with providers, clients and brokers on a timely basis for any rejections or relevant concerns.

Applications to be sent quoting the Job Reference Number and Designation given above


Responsibilities

1. Obtaining daily reports of admissions from the various service providers
2. Managing the Broker/customer communications and communicating information on a timely basis
3. Care Management - Through due diligence, ensuring undertakings and declines are processed accurately and issued in line with the policy provisions
4. Visiting of patients at the various service providers, and confirming that admitted members are the eligible policy holders/ dependents
5. Confirming that the treatment the member is given is covered by the policy purchased
6. Ensuring that the medical reports in the hospital are accurate and reflective of what is provided to the insurer and also confirm what the member understands or communicates
7. Ensuring proper care and treatment of patient within acceptable protocols without wastage by member/ provider
8. Reviewing medical pre-authorizations for compliance with applicable policy guidelines and giving guidance to the other care management team on any information collected during the visits to the hospitals
9. Interacting with clients, brokers and clinicians as needed, to resolve problems in a manner that is legal, ethical and consistent with the principles of the policy
10. Obtaining medical information from providers with written correspondence if necessary
11. Participating in care management meetings
12. Checking and confirming membership validity and benefits (from the scheme benefits file)
13. Handling of coverage enquiries with brokers, providers, members etc.
14. Vetting and confirming validity of the service given by the service provider in relation to the benefits covered, treatment given, adherence to provider panel rules and cost of treatment
15. Obtaining additional required information on claims from providers, brokers or clients
16. Assisting in conducting provider audits wherever necessary.
17. Conducting client presentations and member education
18. Managing the 24-hour emergency helpline



General Information

Salary rangeNot specified
Additional informationNot specified
Contract type: Permanent
Job type: Full Time
Location: Eldoret
Area of work: Medical, health
Seniority: Manager (team leader)

Job Requirements

Required education: Bachelor's degree
Required relevant work experience: 5 years
Required skills: Conflict and complaint resolution; Reporting; Customer service; Patient care; Health insurance; Documentation and record keeping
Required languages: English (Spoken: fluent | Written: fluent)

Click to apply

Jubilee Insurance KE

Banking, microfinance, insuranceCompany size: 1000+ people

Jubilee Insurance was established in August 1937, as the first locally incorporated Insurance Company based in Mombasa in 1937. Jubilee Insurance has spread its sphere of influence throughout the region to become the largest Composite insurer in East Africa, handling Life, Pensions, general and Medical insurance. Today, Jubilee is the number one insurer in East Africa with over 450,000 clients. Jubilee Insurance has a network of offices in Kenya, Uganda, Tanzania, Burundi and Mauritius. It is the only ISO certified insurance group listed on the three East Africa stock exchanges – The Nairobi Securities Exchange (NSE), Dar es Salaam Stock Exchange and Uganda Securities Exchange. Its regional offices are highly rated on leadership, quality and risk management and have been awarded an AA- in Kenya and Uganda, and an A+ in Tanzania.


Other Jobs at Jubilee Insurance KE

UI/UX Engineer
Senior Accountant, Financial Reporting, Planning & Analysis
Senior Care Manager
Data & Records Manager
Mobile Developer
View more jobs at
Jubilee Insurance KE