Managed Care Officer (Rivers) in a Growing Multi-specialist Healthcare Group - Dragnet Solutions Limited

About this role

A full-time Managed Care Officer role based in Port Harcourt, Rivers, for a growing multi-specialist healthcare group. The role focuses on managing day-to-day interactions with HMOs and retainership schemes, handling verifications, authorisations, referrals and claims to support enrollee care and timely reimbursements.

What you would do

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

What they are asking for

• First degree or HND in a relevant field (e.g., Health Sciences, Nursing, Public Health, Business Administration or related).
• Completion of NYSC or valid exemption where applicable.
• At least 4 years of experience in managed care, health insurance, HMO operations or hospital claims/billing.
• Experience handling authorisations, claims and enrollee queries.
• Experience working with clinical teams to deliver care within scheme rules.
• Knowledge of HMO and retainership processes, authorisations and claims.

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