Latest Medical Jobs In Kenya

Care Management Assistant At Britam – APPLY NOW

  • Job TypeFull Time
  • QualificationBA/BSc/HND , Diploma
  • Experience5 – 8 years
  • LocationNairobi
  • Job FieldInsurance  , Medical / Healthcare 

Job Purpose: 

Reporting to the Team Leader Corporate Care Management, The role holder will be responsible for control and managing of the policy cycle through pre-authorization and case management, to ensure  quality and cost effective care.

Key responsibilities:

  • Set the appropriate parameters for each admission (claim reserve, initial authorized cost and duration)
  • Interact with clients and service providers to ensure that the care is given within policy guidelines.
  • Review medical reports and claims for compliance with set guidelines.
  • Liaise with underwriters on scope of cover for the various schemes.
  • Ensure that medical scheme members are attended to round the clock with support from 24 hour call centre.
  • Poly-Pharmacy – discourage poly-pharmacy by diligent challenging of prescriptions and suggesting better alternatives.
  • Generic substitution – Encourage use of generics where indicated as a method of reducing the organizations pharmaceutical expenditure.
  • Prepare periodic reports for management on medical claims.
  • Ensure claims are processed within the stipulated time.
  • Delegated Authority: As per the approved Delegated Authority Matrix.

Key Performance Measures:

  • As described in your Personal Score Card.

Knowledge, experience and qualifications required

  • Diploma/Degree in Nursing or Diploma in clinical medicine or Diploma in Pharmacy.
  • Moderate understanding of insurance concepts.
  • Professional qualification in FLMI, ACII and IIK.
  • 5-8 years’ experience in case management two of which should be in a supervisory position.

Technical/ Functional competencies:

  • Knowledge of insurance regulatory requirements.
  • Knowledge of insurance products.
  • Sales and marketing management skills.

Method of Application

Interested and qualified? Go to Britam on to apply

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