The Kenyan Alliance Insurance is a leading Insurance Company offering a wide range of financial products and services. Our product range includes life and general insurance, pensions, investment planning, retirement planning and medical insurance.
As part of our growth strategy, the Company seeks to recruit dynamic, passionate, innovative and result orientated professional to the position below.
The Care Manager will work directly with patients, assess patient care required throughout continuum of care for diagnosis, procedures.
Duties and Responsibilities;
Reporting to the Head of Healthcare, the person will be responsible for the following duties;
• Inform patients regarding general preventative care practices as well as individualized care plans.
• Keep track of patients' records, especially electronic records, and keep current with computer technology, software, security measures, legislation regarding patient privacy and other issues.
• Streamlining business operations and instituting measures to improve care.
• Analyzing business processes, creating and reviewing budgets, coordinating with other managers, and assessing business performance.
• Use technological advancements to improve business operations and streamline processes.
• Create schedules, evaluate personnel, and give performance reviews.
• Handle the 24 hour emergency line and customer service delivery.
• Pre- authorizing dental, optical and all admissions as per set guideline.
• Generate in patient claim analysis reports and make recommendations on areas of improvement.
• Participate in pitching for business.
• Reviewing medical reports and claims for compliance within guidelines.
• Provide technical expertise on case management.
• Organize health talks and customer education in liaison with marketing and underwriting department.
• 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.
• Graduate with a degree preferably in Nursing or a relevant field
• At least 5 years relevant experience
Key Competencies and Skills Required
• Good understanding of Case Management.
• Mature, team player with supervisory skills.
• Proficient in the use of Microsoft office suite and packages.
How to apply.
Only shortlisted candidates will be contacted.