CARE OFFICER (INTERNAL APPLICANTS ONLY)

About Us CIC Insurance Group is a leading insurance and financial services organisation with more than five decades of experience helping individuals, families, and organizations achieve financial security. We have grown into a dynamic Group offering life, general, micro insurance, asset management, and investment solutions, with operations in Kenya, Uganda, South Sudan, and Malawi, and are listed on the Nairobi Securities Exchange. Our tagline, “We Keep Our Word,” reflects our unwavering commitment to integrity, transparency, and delivering on our promises to our clients, partners, and communities. CIC Group is passionate about innovation, digital transformation, and inclusive insurance solutions that meet the evolving needs of cooperatives, SMEs, corporates, and individuals. By joining us, you will be part of a team that is shaping the future of financial protection across Africa.

About the Role Responsible for care facilitation/cost containment and call centre reachability.

Key Responsibilities:

• Issuance of approval to insured members seeking both inpatient and outpatient care as per policy guidelines
• Monitor cost, average length of stay on inpatient cases
• Issue guidance on Pre-authorized optical, dental and scheduled procedures
• Conduct Hospital visits whenever the insured members are hospitalized
• Respond to stakeholder inquiries on cases involving medical care management
• Receive and respond to Medical emergency lines and ensure 24-hour coverage
• Negotiate for discounts from doctors and hospitals on specific cases and procedures from time to time
• Facilitate referrals and medical evacuations when need be
• Monitor benefits utilization and share timely updates to the stakeholders
• Prepare and share timely reports as may be guided

Who We’re Looking For

Essential Knowledge/Skills and Experience Required:

• Diploma in Nursing or Clinical Medicine
• Minimum of 2 years of experience in Care Management, medical claims and call centre