Resolution Insurance Care Manager Job in Kenya

Resolution Insurance Company Ltd is a general insurer offering innovative and responsive insurance solutions. 

We have learned to adapt in this constantly changing society, and develop comprehensive products that are relevant to our clients. 

We currently have over 60,000 members in our fold and have partnered with over 500 medical service providers across East Africa; a strong network of hospitals, clinics and doctors.
 

The Resolution Insurance brand is energetic and trendy. 

In pursuit of our ambitious growth plan, we are looking to fill the below position in our Medical Operations Department. 

Care Manager
 

Reporting to the Head of Care Management, the Care Manager’s purpose is to monitor, evaluate and coordinate medical benefit utilization to ensure quality, appropriate and cost effective care.
 

Key Responsibility Areas:

• Coordinate the integration of care management functions into the patient care.


• Conduct concurrent medical record review using specific indicators and criteria as approved by Resolution Insurance.


• Investigate and report adverse occurrences relating to client’s management, policy with appropriate action to ensure compliance with quality patient care.


• In liaison with the physician, maintain appropriate cost, case, and desired patient outcomes.


• Evaluate patient satisfaction and quality of care provided.


• Assess patient care required throughout continuum of care for diagnosis procedures.


• Communicate with physicians at regular intervals throughout hospitalization and develop an effective working relationship.


• Assess patient’s progress through expected hospital course.


• Facilitate interdisciplinary patient care to review treatment goals and identify post-hospital needs.

Qualifications and Experience:

• Degree/Higher National Diploma in Nursing or Clinical Medicine.


• KRCHN Registration


• At least 1-3 years relevant working experience.


• Good interpersonal, communication and negotiation skills.


• Basic knowledge of computers and office operating programmes.


• Experience in an Insurance company.


• A valid driving license.


• A proven ability to build strong client relationships and maintain an excellent customer focus.

If you believe you are a team player and would be a valuable resource to this ever growing brand, kindly CLICK HERE to apply online by COB, Wednesday, 29th June 2015.