Leading Health Maintenance Organization (HMO) Vacancy for Branch Lead (Medical)

Total Health Trust Limited (THT), Nigeria’s leading Health Maintenance Organization (HMO) was founded in 1997 and commenced operations in June 1998. Renowned by our stakeholders for our reliability, we have been connecting our members to healthcare providers since 1998. Our unrivalled 18 years industry track record has seen us build a formidable reputation in Nigeria and we remain the HMO of choice for over 300,000 members and over 500 corporate clients and government institutions. We were the first HMO to be registered in Nigeria and 18 years later, we are still number one in the market. We are one of the very few HMOs that can boast the financial and technical backing of a world class company - Liberty Health (a member of the Liberty Group).

We are recruiting to fill the vacant position below:

Job Title: Branch Lead (Medical)

Location:
 Calabar, Cross River 

Job Description

  • To facilitate the investigation of potential fraudulent claims within the specific branch
  • Hospital visits regarding specific branch cases
  • To provide services in the accreditation and re-accreditation of branch providers to ensure that provider facilities and services are up to standard as per the agreed standards using a standardized checklist
  • To adhere to and live the organizational values
  • Following Head Office approval, to ensure a successful provider forum is held as stipulated
  • To ensure provider education is done and ensure product knowledge and processes are understood towards seamless service delivery to enrollees
  • To manage specific cases in the branch in order to get the best outcome
  • To facilitate the process of pre-authorisations and authorisations between the provider and the scheme and to give feedback to the relevant party concerned
  • To facilitate resolution of all queries from providers and members within the branch on specific cases and within the agreed SLA
Requirements
  • Candidate must be a registered nurse and midwife
  • B.Sc Nursing and additional medical qualification will be an added advantage
  • Candidate must have minimum of 3 years medical experience including 2 years in similar role in an Health Maintenance Organization (HMO)
  • Candidate must have advanced knowledge of NHIS regulatory guidelines, Medical Global Best Practices, Health Insurance, Products and Processes, and Scheme Rules.
  • Excellent organizational, communication (verbal and written), listening skills and attention to detail.
  • Candidate must be very proficient in Microsoft office packages
Other Requirements:
  • Good organizational and planning capabilities
  • Innovative and quick thinking capabilities
  • Adaptive
  • Decision Making skill and Excellent Customer Service Skill
  • Integrity
  • Ability to work under pressure
  • Adaptive, expertise, Result-Oriented, Relationship Skill
  • Working with people
  • Interpersonal Skill
  • Must be a good collaborator/Team player


How to Apply
Interested and qualified candidates should:
Click here to apply online

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