Consultant Care Management (Mombasa) at Zamara Kenya

Zamara is a financial services firm that primarily offers Actuarial Services, Pensions Administration and Consulting and Insurance Brokerage Services. Zamara has been in the Kenyan Market for over 23 years, initially operating as Hymans Robertson and more recently as Alexander Forbes. Working at Zamara offers our people the opportunity to work for a Truly Pan-African Financial Services firm.

 

Consultant Care Management (Mombasa)

  • Job TypeFull Time
  • QualificationDiploma
  • Experience1 year
  • LocationMombasa
  • Job FieldConsultancy  , Medical / Healthcare 

KEY ROLES AND RESPONSIBILITIES

Care Management

  • Manning calls on the 24-hour medical emergencies help lines
  • Facilitate approval and authorisation for Emergency Inpatient hospitalisation e.g. post road traffic accidents from the insurance companies/underwriters.
  • Outpatient treatment authorisation (off smart/ no card)
  • Facilitate evacuation processes to ensure favourable outcomes and reasonable charge to clients.
  • Preauthorization request processing and hospital procedure booking including maternity and theatre procedure bookings.
  • Liaising with the Insurance companies in the process of undertaking and pre-authorizations.
  • Provider panel management – ensuring required facilities are onboarded and favourable relationship is always maintained.
  • Advocating for clients
  • Negotiation of borderline claims
  • Support with overseas referral
  • Offer dedicated services to clients at their premises.

Reporting

  • Provide data reports collected from various monitoring tools assigned to the role e.g. weekly and/or monthly reports.
  • Trend analysis – hospital charges, cost of various packages etc

Value Adds

  • Facilitation of admission and discharge processes for patients by securing all necessary documents and ensuring minimal participation by the patient during the admission or discharge.
  • Facilitation of special care for admitted patients e.g haircuts for executive clients at the bed side/ flowers.
  • Issuing Zamara gift packs - pack of diapers, branded get well / birth congratulations to admitted patients.

SKILLS AND QUALIFICATIONS 

  • A Diploma in Nursing Sciences/ Clinical medicine
  • Minimum of one (1) year working in a hospital set up/ health facility/medical insurance care department
  • General understanding of the insurance industry is an added advantage.
  • Capacity to build relationships
  • Business etiquette
  • Excellent interpersonal and customer service skills
  • Team player
  • Problem Solving skills
  • Self-Driven
  • Flexible to train

Check how your CV aligns with this job

Method of Application

Interested and qualified? Go to Zamara Kenya on zamara.bamboohr.com to apply

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