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Coordinator, Managed Care Services in a Growing Multi-Specialist Healthcare Group - Dragnet Solutions Limited
About this role
A full-time role leading the hospital’s managed-care function, focusing on HMOs and retainership schemes to ensure quality patient care and commercial sustainability. Suitable for experienced professionals with a background in managed care, HMO operations, or healthcare administration.
What you would do
- Oversee enrolee verification, pre-authorisation, referrals and care within scheme terms
- Direct managed-care operations and manage relationships with HMO and retainership partners
- Supervise and develop managed-care, clinical support and customer experience staff
- Monitor service-level agreements and resolve disputes with scheme partners
- Oversee claims preparation, submission, reconciliation and follow-up to minimise rejections and delays
- Coordinate with clinical teams to ensure evidence-based, cost-effective care within scheme rules
What they are asking for
- First degree in a relevant field (Health Sciences, Nursing, Public Health, Business Administration or related)
- Completion of NYSC or valid exemption
- Experience coordinating claims, authorisations and HMO relationships
- Minimum of 8 years in managed care, HMO liaison or healthcare administration with supervisory experience
- Strong communication, negotiation and analytical skills
- Experience leading a team and managing revenue-cycle management
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