CARE COORDINATOR / PROVIDER MANAGER-VACANCY AT INTERNATIONAL HEALTH MANAGEMENT SERVICES (IHMS)

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