Coordinator, Managed Care Services (Edo)

About this role

Role: Coordinator, Managed Care Services for a growing multi-specialist healthcare group in Edo. The role leads the hospital’s managed-care operations, manages relationships with HMOs and retainership partners, and ensures enrolee service, claims and authorisation processes deliver quality care and commercial sustainability.

What you would do

• Direct the hospital's managed-care operations and manage relationships with HMO and retainership partners.
• Oversee enrolee verification, pre-authorisation, referrals and care management within scheme terms.
• Oversee claims preparation, submission, reconciliation and follow-up to minimise rejections and delays.
• Monitor service-level agreements and resolve disputes with scheme partners.
• Coordinate with clinical teams to ensure care is evidence-based, cost-effective and within scheme rules.
• Supervise and develop managed-care, clinical support and customer experience staff.

What they are asking for

• A relevant first degree in Health Sciences, Nursing, Public Health, Business Administration or related discipline.
• Completion of NYSC or valid exemption where applicable.
• Minimum of 8 years of relevant experience in managed care or healthcare administration, including supervisory experience.
• Strong knowledge of managed-care, HMO and retainership processes, and claims, authorisation and revenue-cycle management.
• Working knowledge of managed-care/claims systems and performance reporting.
• Experience coordinating claims, authorisations and relationships with HMOs or schemes; experience supervising staff and interfacing clinical and commercial functions.

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