Managed Care Officer (Edo)

About this role

Role: Managed Care Officer based in Benin, Edo. It is a full-time position with a growing multi-specialist healthcare group, with Dragnet Solutions Limited handling the recruitment. The officer will oversee day-to-day liaison with assigned HMO and retainership schemes, processing enrolee verification, authorisations, referrals and claims to support care and timely reimbursement.

What you would do

• Check enrollee eligibility and handle pre-authorisation and referral requests per scheme terms
• Prepare, submit, monitor and reconcile claims; follow up on rejections and overdue payments
• Liaise with scheme partners on authorisations, queries and disputes
• Coordinate with clinical teams to ensure care complies with scheme rules and is properly documented
• Address enrollee enquiries and complaints, escalating as needed
• Maintain accurate managed-care records and generate regular activity reports

What they are asking for

• A relevant First Degree or HND in Health Sciences, Nursing, Public Health, Business Administration or related discipline
• Completion of NYSC or valid exemption where applicable
• Minimum of 4 years of relevant experience in managed care/HMO operations, health insurance or healthcare administration
• Working knowledge of HMO and retainership processes, authorisations and claims
• High attention to detail and accuracy in claims and records; competent use of relevant claims/records systems
• Strong communication and ability to liaise effectively with scheme partners and clinical teams

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