₦airaland Forum

Our client, Nigeria’s first advanced paramedic (Emergency Medical Services) company is looking for passionate Provider Network Operations Manager to join its team.

Job Designation: Practice Manager
Job Location: Lagos, Contact Centre

Person Specification:
• Minimum Education: MBBS
• Minimum Inherent Job Experience Required: Medical Contact Centre
• Desirable Experience: 5 Years Operational Experience with 2 Years CC/Case Management experience
• Competencies:
• Strong clinical background with emphasis on problem- solving and analytical skills.
• Strong knowledge of medical treatment protocols
• Familiarity with ICD-9 and 10 codes
• Knowledge of medical causations and relatedness
• Communication verbal and written
• Prioritize tasks and responsibilities
• Planning/Organizing
• Interpersonal skills
• Business Acumen
• Negotiation

Responsibilities
Case Management
• Case management with all Clients
• In-house telephonic medical case management and advice
• Home visits to members
• Maximize the use of our preferred physicians whenever possible.
• Provide exceptional customer service through proactive communication with external customers and internal business partners.
• Provide technical assistance and act as resource for claim handling staff.

Medical Leadership
• Managing Chronic Diseases for and on behalf of members
• Oversee all cases and referrals
• Oversees transition, continuity, follow up of members
• Overall management of all medical Operations, Clinical Governance and direct medical leadership within the region.
• Ensure strict adherence to the medical ethics and standards as well as Health and safety subjects concerning the practice.
• Oversee and maintain all CRI’s Standard operating policies and procedures.
• Ensure compliance with all statutory and obligatory medical requirements within scope of practice
• Support all operational activities while providing assistance to ground medical staff at all times.
• Maintain strict confidentiality in all dealings pertaining to the scope of practice
• Arrange regular clinical meetings, share best practices and case review

Occupational Health
• Co-ordinate all Occupational health activities within the practice
• Ensures all medical staff carry out duties and responsibilities professionally with a full continuum of care.
• Consult and attend to patients daily
• Ensure medical staff certifications are up to date.
• Maintain strict compliance with laid down HSE procedures
• Liaise with the MRO on all circumstance relating to Substance abuse testing
• Ensures proper documentation of all Occ health activities and generate weekly report for the head office
• Arrange for medical staff to attend or administer all Occ health request on-site and offsite
• Continually liaise with the Head of Industrial health on all Occ health issues.

Administration
• Review performance measurement reports
• Promote functional teamwork
• Utilization Reviews
• Statistics and reporting
• Records management and case sheets
• Develop, review and implement procedures to meet customer requirements
• Prepare Utilization reports for Clients
• Providing the Billings Department with accurate information for payments, Medical Insurance and Client Billings
• Assisting with any other management tasks requested by Senior Management
• Ensure all case notes and details regarding patients is captured on the EMR

Human Resources
• Continuous training, development and management of staff and performance manage staff

Finance
• Deliver a service within budget and agreed performance
• Cost containment and efficient utilization of resources
• Monitor income and expenditure
• Profitability of cases and the use of third parties/service providers
• Risk identification and management
• Product development and offering

Quality Assurance
• Manage and improve the quality of services provided by contact centre, clinical staff, customer experience officers and home visits
• Manage and improve the quality of third parties / service providers
• Analyze, review and recommend on technical and operational software
• Liaise with IT to ensure accurate databases are always maintained

Interested candidate should send their CVs to gts.recruitments@gmail.com with job title as the subject of the mail