Resolution Insurance Care Manager Job in Kisumu, 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 Division, Kisumu Office. 

Care Manager – Kisumu

Reporting to the Head of Care and Medical Advisory, the Care Manager’s purpose is to monitor, evaluate and coordinate patient care within the medical benefit to ensure quality, appropriate and cost effective care, ensuring good business relationship with existing, new and potential Medical Service Providers.

Key Responsibility Areas:

• Pre-authorization of admissions both emergencies and scheduled to ensure validity, legitimacy of admission, and advice on cover scope. 


• Liaise with medical service providers to obtain RI client medical reports to ensure they are getting optimal, quality care as most appropriate. 


• Negotiate professional fees for each admission to ensure clients are receiving cost effective care within the scope of their cover. 


• Manage the 24-hour helpline and ensure client enquiries are sorted to satisfaction and assist with medical emergencies logistics


• Visit all admitted clients to ensure they are getting appropriate satisfactory care and that necessary advice is given from admission to discharge


• Maintain good working relationship with the Medical service Providers including appointments trainings and claims dispute management.

Qualifications and Experience:
 

Essential:

• 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.

Desirable

• 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 visit www.resolution.co.ke by COB, Friday, 14th December 2015.