• The ideal candidate will be responsible for implementing guidelines that ensure a balanced ratio of favorable risks, minimizing claim costs, and enabling the company to provide insurance at competitive premiums.
• This role requires a comprehensive understanding of risk analysis/management, professional analysis of data and make informed decisions.

Duties and Responsibilities

• Work directly with the Medical/Quality Assurance department to meticulously monitor and review all approval for secondary and or tertiary services and ensure that all approvals are consonance with the agreed tariffs of the program, either it is the public sector social health insurance program the private health insurance program or the tertiary institution social health insurance program.
• For private insurance programs, monitor the process of giving approvals from the primary level all the way to the exit point in order to minimize leakages and abuse
• Investigate any identified fraud cases and bring such cases to the attention of management for appropriate action.
• Work collaboratively with others in the marketing department to determine appropriate premiums for intending or prospective clients at all times to manage risk exposure.
• Collaborate with the medical team to review case notes in facilities within the reach of the organization to eliminate abuse of pre-authorization codes by HCFs.
• Coordinate and oversee the maintenance of good record keeping both online and physically to ensure easy retrieval of information at all times.

Qualifications And Experience

• Applicants must possess a degree in any related field from a reputable tertiary institution
• Possession of MBA or MSC certificate will be required and serve as added advantage
• Possession of other relevant certificates in business management and or other areas of administration will be required and serve as added advantage.
• Up-to-date registration and license from the MDCN

Experience:

• Minimum of 3 years’ experience working as an Underwriter and at least 7 years’ post-NYSC experience