Reliance Health
Case Manager (Freelance)
Kano, Abuja • Nigeria
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Reliance Health
Health care + 1 more
Description
What You'll Bring
- Bachelor of Medicine, Bachelor of Surgery (MBBS or equivalent) or Bachelor of Nursing (BNS)
- Valid, unrestricted medical or nursing license to practice in Nigeria
- Minimum of 3 years of clinical practice experience
- Strong understanding of clinical guidelines and standards of care
- Experience in clinical audits, case review, or hospital practice
- High level of integrity and adherence to medical ethics
- Strong analytical and reporting skills
- Ability to work independently in field-based environments
Responsibilities
- Conduct on-site clinical reviews at assigned healthcare facilities.
- Review patient cases to assess clinical appropriateness, quality of care, and adherence to established standards.
- Perform morbidity and mortality audits to evaluate patient outcomes and identify opportunities for improvement.
- Provide structured, evidence-based recommendations following clinical reviews and audits.
- Identify patterns of unnecessary, excessive, inappropriate, or potentially fraudulent healthcare services.
- Investigate suspected cases of fraud, waste, and abuse at healthcare facility level and document findings accordingly.
- Escalate critical issues and high-risk findings to the appropriate internal stakeholders.
- Provide independent clinical opinions and recommendations based on reviewed cases and available evidence.
- Prepare detailed reports and documentation following facility visits and case reviews.
- Support internal teams with insights and recommendations on complex clinical cases and healthcare delivery concerns.
- Engage professionally with healthcare providers and facility representatives during reviews and investigations.
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