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Job Description
Inspection of healthcare facilities and accreditation of new facilities for onboarding and re-credentialing.
Responsibilities
- Inspection of healthcare facilities and accreditation of new facilities for onboarding and re-credentialing.
- Annual recertification/re-credentialing of all Providers.
- Annual collection of LONI certificates from all Providers.
- Provider relationship management and Provider Forums.
- Provider staff education – Provider induction at sign-on and ongoing education.
- Scheduling and carrying out quality assurance (QA) visits.
- Assist with Pre-authorization of care based on the company’s pre-authorization guidelines and procedure.
- Investigating complaints from hospitals and responding to such correspondences.
- Investigating medical-related complaints from clients and responding to such correspondences.
- Health promotion (education, screening, etc.) and health benefit utilization education for clients.
- Concurrent and retrospective reviews of Enrollee feedback
- Providing approved billing guides and tariffs to hospitals
- Providing timely reports on Provider management
- Providing IHMS with feedback on Provider Relationship with IHMS
- Following up and getting feedback from Enrollees on admission Care
- Ensuring all correspondences with Providers are documented in email, reporting structure, survey, or formal report as much as possible.
Qualification
- Possess relevant qualifications
- HMO experience will be an added advantage
Interested and qualified candidates should send their Resume to: ihmsresponses@gmail.com using the Job Title as the subject of the email.
Location: Abuja, Edo, Lagos, Niger, and Rivers Nigeria.
For More Information: CARE COORDINATOR / PROVIDER MANAGER
