Job Information
Managed Care Manager (Health Insurance Services)
Proserve Client 59 Days Ago
Overview
Job Type: Full-Time
Duration: Permanant
Job Salary Range: $ - Negotiable
Department:
Job Category: Pharmacists/ Health/ Medicine
Sub Category:
Job Shift:
Posted: 19-11-2020
Zipcode:
Requirements
Minimum Education: University Degree
Degree Title: Health, Business
Minimum Experience: 5 Years
Age: -
Job Status
Job Status: Sourcing
Start Publishing: 19-11-2020
No of Jobs: 1
Stop Publishing: 30-12-2020
Share on Google+ Friend Feed Share on Blog Linkedid MySpace Twitter Yahoo Share on Digg Share on facebook
Location
Description

Reporting to the Operations Executive, the successful candidate will be responsible for the following:
RManaging hospitalization, procedures and prescriptions quotation/requests
Maintaining relationships with various business functions across the organization including health unit, legal, and
regional/country offices.
Drafting Standards of Operations for the department.
Analyzing data and recommending cost models for continuous improvement.
Providing technical advice and guidance to members and providers
Initiating prosecution, suspension or termination proceedings for the investigated cases
Monitoring and managing daily received telephone walk ins, email, postal enquiries and quotations from providers and members
Identifies training gaps and needs and recommend training
Drafting memorandum of agreement for network service providers
Coordinating community medical outreach programs

Qualifications

Bachelor’s degree in Health or business field preferred
3-years’ experience in a similar or related environment.
Minimum 2 years of supervisory experience
Must be proficient with systems

 

 

 

 

 

Prefered Skills

Self-starter, innovative, and energetic
Extrovert
Work with minimal supervision
Strong business acumen with sound commercial judgement
Must possess exceptional analytical skills
Risk Management exposure
Must possess exceptional people and negotiation skills for interactions with different stakeholders.
Effective communication and customer services skills
Experience negotiating contracts and terms and financial modeling preferred

 

 

 

 

 

Facebook Comments
Apply Now