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Coordinator, Managed Care Services (Kaduna)
About this role
The role of Coordinator, Managed Care Services in Kaduna leads the hospital’s managed-care function, including managing relationships with HMOs and retainership partners. It covers enrolee service, pre-authorisation, referrals and care within scheme terms, and overseeing claims to support quality care and commercial sustainability. The position is for an experienced professional with a background in managed care and healthcare administration.
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 management of care within scheme terms.
- Oversee claims preparation, submission, reconciliation and follow-up to minimise rejections and delays.
- Monitor service-level agreements and lead resolution of disputes with scheme partners.
- Coordinate with clinical teams to ensure care is evidence-based, cost-effective and within scheme rules.
- Supervise, coach and develop managed-care, clinical support and customer experience staff.
What they are asking for
- Minimum of 8 years of relevant experience in managed care, HMO liaison or healthcare administration, including supervisory experience.
- Substantial experience in managed care, health insurance, HMO operations or hospital revenue-cycle management.
- Experience coordinating claims, authorisations and HMO/scheme relationships.
- Experience supervising staff and managing service performance.
- A relevant first degree (health sciences, nursing, public health, business administration or related discipline) with NYSC completion or valid exemption.
- Strong communication, negotiation and analytical skills; working knowledge of managed-care/claims systems and performance reporting.
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