4 weeks ago
Job title : Care Coordinator/Provider Manager – Edo
Job Location : Edo
Deadline : March 06, 2024
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MUST BE A MEDICAL DOCTOR/ NURSE
RESPONSIBILITIES OF CARE COORDINATOR/PROVIDER MANAGER
- Inspection of healthcare facilities and accreditation of new facilities for onboarding and re-credentialing.
- Annual recertification/re-credentialing of all Providers.
- Annual collection of LONI certificates from all Providers.
- Provider relationship management and Provider Forums.
- Provider staff education Provider induction at sign-on and ongoing education.
- Scheduling and carrying out quality assurance (QA) visits.
- Assist with Pre-authorization of care based on the company’s pre-authorization guidelines and procedure.
- Investigating complaints from hospitals and responding to such correspondences.
- Investigating medical-related complaints from clients and responding to such correspondences.
- Health promotion (education, screening, etc.) and health benefit utilization education for clients.
- Concurrent and retrospective reviews of Enrollee feedback
- Providing approved billing guides and tariffs to hospitals
- Providing timely reports on Provider management
- Providing IHMS with feedback on Provider Relationship with IHMS
- Following up and getting feedback from Enrollees on admission Care
- Ensuring all correspondences with Providers are documented in email, reporting structure, survey or formal report as much as possible.
CARE COORDINATOR DUTIES
- Reach out to Patients on Admission
- Call or visit Patients during or at most one (1) week after admission
- Use the structured template to collect Patient reviews on Providers
- Provide feedback and utilization data
- Get feedback from Enrollees on treatment at various facilities
- Report on Enrollee utilization for each facility every year
- Reduce overbilling and over-treatment
- Follow-up issues raised by the Claims Department to help Providers improve services.
How to Apply for this Offer
Interested and qualified candidates should apply using the Apply Now button below.
- Medical / Healthcare jobs
- Care Coordinator/Provider Manager – Edo jobs