Managed Care Officer (Kaduna)

About this role

Dragnet Nigeria seeks a Managed Care Officer in Kaduna to manage the day-to-day interface with assigned HMO and retainership schemes, handling enrolee verification, authorisations, referrals and claims to support smooth enrolee care and timely reimbursement. The role targets professionals with at least four years of relevant experience in managed care/HMO operations and a relevant degree or HND.

What you would do

• Verify enrolee eligibility and process pre-authorisation and referral requests within scheme terms.
• Prepare, submit, track and reconcile claims, and follow up promptly on rejections and outstanding payments.
• Liaise with assigned scheme partners on authorisations, queries and disputes.
• Coordinate with clinical teams to ensure care is delivered within scheme rules and properly documented.
• Respond to enrolee enquiries and complaints, escalating as needed.
• Maintain accurate managed-care records and produce regular activity reporting.

What they are asking for

• Minimum of 4 years of relevant experience in managed care/HMO operations, health insurance or healthcare administration.
• A relevant first degree or HND in health sciences, nursing, public health, business administration, or related discipline.
• Completion of NYSC, or a valid exemption where applicable.
• 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.

Listing details are summarised from the source. Always confirm the role and the employer on the original posting before applying, and never pay to apply for a job.