PURPOSE:
Responsible for care facilitation/cost containment and call centre reachability.
PRIMARY RESPONSIBILITIES:
- Issuance of approval to insured members seeking both inpatient and outpatient care as per policy
- Monitor cost, average length of stay on inpatient
- 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
- 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
- Monitor benefits utilization and share timely updates to the
- Prepare and share timely reports as may be guided.
| Key Skills, Knowledge, Experience and Behavioral Competencies | |||||||||||||||||||||||||
These are defined as; Academic and Professional Requirements
Experience Required: |
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| Description | Required years of experience | Need Type | |||||||||||||||||||||||
| Relevant experience in Care Management, medical claims and call centre | 2 | E | ||||||||||||||||
Behavioral CompetenciesThese are defined as:
|
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| Core Competencies | Proficiency Required | |||||||||||||||||
| 1. Customer Focus | B | |||||||||||||||||
| 2. Business Acumen | B | |||||||||||||||||
| 3. Driving Innovation | B | |||||||||||||||||
| 4. Driving Business Performance | B | |||||||||||||||||
| 5. Negotiation and Influence | B | |||||||||||||||||
| 6. Effective Communication | B | |||||||||||||||||
| Leadership Competency | Proficiency Required | |||||||||||||||||
| 1. Planning and organizing | B | |||||||||||||||||
| 2. Accountability | B | |||||||||||||||||
| 3. Quality Decision Making | B | |||||||||||||||||
| 4. Building Partnerships | B | |||||||||||||||||
| 5. Continuous Learning | B | |||||||||||||||||
| 6. Emotional Intelligence | B | |||||||||||||||||
| 7. Conflict Management | B | |||||||||||||||||
| Special Position Requirements ( Optional section: any travel, security, hazard or related special conditions which apply to the position) | ||||||||||||||||||
| · The role holder may be required to travel to distant branches or wherever the Company has any interest.· Role holder may be required to work extended working hours to ensure jobs are completed on schedule and to specification. | ||||||||||||||||||
If you have the aforementioned professional and academic qualifications and you are ready to execute the above mandate, strictly apply through: https://careers.cicinsurancegroup.com/ clearly indicating the position being applied for.
The application should reach us by close of business on 7th November, 2024. Please note only short-listed candidates will be contacted. If you do not hear from us by 30th November, 2024 consider your application unsuccessful.
