Job role: Medical Doctor

Location: Lagos

Monthly Salary: 200,000

Job Description
• Case management of enrollee complaints, diagnosis and treatment at the provider to ensure cost-quality of care balance is maintained
• Checking vetted claims for accuracy and correctness in line with diagnosis
• Evaluate the performance and reliability of Health Care Providers (HCP) by carrying out random spot checks on enrollees to corroborate claims by HCPs – ratio of 1:10 spot checks monthly
• Periodic checks on activities and processes of HCPs, by QA calls, visits or surveys to HCPS
• Analyze Provider reports for management information
• Provide managed care services
• Recognize and fix weaknesses in the system
• Manage all HMOs units to deliver on their deliverables daily
• Provide leadership and ensure that HCP meets quality checklist for onboarding
• Develop and implement necessary quality policy as guidelines for Provider manager department
• Implement quality checklist to follow to approve HCP into our network
• HCP/Enrollee Complaint escalations
• Courtesy calls on existing and prospective customers

Key Results Areas
1. Quality Assurance
2. Providers Management
3. Case Management
4. Client Relationship Management

Qualification and Attributes
1. Qualification: MBBS degree from a recognized university in Nigeria
2. Experience: 3-5 years’ experience in a recognized HMO. Experience in Providers Management, Claims Management or Client Relationship Management are key requirements for this role
3. Attributes: Leadership skill, very organized & pay attention to details, He must be proficient in the use of computer, strong analytical & problem-solving skills

Interested candidate should send their CV to recruitment@fortknoxoutsourcing.com using Job role as Subject