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Managed Care Medical Officer needed at DEDA Hospital

Job title : Managed Care Medical Officer

Job Location : Abuja

Deadline : April 10, 2024

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Position Overview: 

As a Managed Care Medical Officer, you will play a pivotal role in overseeing and optimizing healthcare delivery within the managed care unit. You will collaborate with various stakeholders to ensure the effective utilization of resources while maintaining high-quality patient care standards. This position requires a combination of clinical expertise, strategic planning, and strong communication skills.

Reports to

QA&QC, Finance Director/ Administration

Direct Report

Customer service officers, nurses, doctors, pharmacy, lab, internal control.

Key Responsibilities:

Clinical Oversight:

  • Provide medical expertise and guidance to ensure the delivery of evidence-based, high-quality care.
  • Review and evaluate medical necessity, appropriateness, and effectiveness of healthcare services and interventions.

Utilization Management:

  • Develop and implement utilization management strategies to optimize resource utilization while maintaining quality care.
  • Review and approve treatment plans, referrals, and requests for medical services in accordance with established guidelines and policies.

Provider Collaboration:

  • Collaborate with healthcare providers, including physicians, specialists, and allied health professionals, to streamline care delivery and enhance patient outcomes.
  • Facilitate communication and coordination among providers to ensure continuity of care and effective care transitions.

Data Analysis and Reporting:

  • Analyze healthcare data to identify trends, patterns, and opportunities for improvement in care delivery and cost containment.
  • Generate reports and metrics to track key performance indicators and outcomes related to managed care initiatives.

Quality Improvement:

  • Participate in quality improvement initiatives to enhance patient safety, satisfaction, and clinical outcomes.
  • Implement best practices and evidence-based guidelines to drive continuous improvement in healthcare delivery processes.

Compliance and Regulatory Oversight:

  • Ensure compliance with regulatory requirements, accreditation standards, and contractual obligations related to managed care operations.
  • Monitor and address issues related to documentation, coding, billing, and claims processing.

EDUCATIONAL QUALIFICATION

  •  MBBS
  • Registration with relevant bodies.   

How to Apply for this Offer

Interested and qualified candidates should forward their CV to: [email protected] using the position as subject of email.

  • Medical / Healthcare  jobs
  • Managed Care Medical Officer jobs

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