Job Description
Aon Kenya, a leading provider of insurance broking, risk management and human capital consulting solutions is looking to fill the following positions in our Healthcare Department;
Medical Insurance Care and Case Managers
for all the following counties: Garissa, Mandera, Marsabit, Tana River, Turkana, Wajir, Siaya & Mombasa
Ref: CM/HLC/09/09/201 5
Job Summary: The role will be responsible for ensuring that all medical scheme members receive appropriate, reasonable health care services by assessing, planning, implementing, coordinating, monitoring and evaluating options and services required to meet scheme members’ health needs and access to care through the preferred provider network to promote quality and cost effective outcomes.
Job Functions:
Maintain good client service as well as addressing all clients’ queries
Authorisation of admission to appointed Medical Service Providers, daily visitation and discharge planning
Interpreting medical policies ¡n managing healthcare clients’ needs
Conduct member education sessions
Coordination and follow up and referral of chronic illness patients on outpatient basis
Coordination of inter hospital transfers, medical evacuation, step down care, home care & nursing care upgrade as per clinical assessment
Carrying out medical audits on the service provider facility to ascertain quality assurance
Cost negotiations with the Doctors on procedure charges and consultation
Accreditation of medical service providers and recommendation for appointment, termination as appropriate
Minimum Qualifications:
Diploma in Nursing or Clinical Medicine
Minimum of 3 years’ experience, preferably care management in a medical insurance firm
Computer skills and especially operating MIS
In-depth knowledge of care and health management
Competencies:
Confidentiality
Good Communication & PR skills
Ability to work under pressure
Analytical and focused individual with attention to detail
How to Apply
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