Organization: AAR Healthcare Uganda Limited
Duty Station: Kampala, Uganda
AAR Healthcare Uganda Limited is the largest provider of outpatient health care services in Uganda having begun its operations in 1994. The company is committed to excellent client experience with a focus on quality provision of health services, by engaging professionally qualified staff, continuous review of its medical practice, systems and processes.
Job Summary: The Head of Claims, Case Management and Underwriting will ensure delivery of appropriate, consistently high quality, cost effective and curative clinical services to all hospitalized AAR members through application of case management. The incumbent will also ensure consistent management of provider relationships through selective contracting and timely payment. The incumbent will ensure efficient and accurate processing of medical claims in keeping with managed care principles.
Key Duties and Responsibilities:
· Responsible for hospitalization costs management
· In charge of clinical risk management
· In charge of claims management
· Responsible for provider relationship management
· Tasked with provider account management
Key Result Areas:
· Ensure prompt vetting of claims from date of receipt within 1 day
· Ensure timely submissions of claims from PPOs referral centres, Health Care and hospitals
· 100 lines of Hospitalization claims assessed in 8.5 hours
· 200 lines of outpatient claims assessed in 8.5 hours
· Timely and accurate processing of claims based on pre-determined standards
· Claims should be ready for payment not later than 5 days from the date received.
· Handling of client queries completely and accurately first time round
· Efficient and accurate problem solving
· Company knowledge 80%
· Staff training
· Performance Management Evaluation at 100% for staff who have been confirmed
· Refund Administration.
Qualifications, Skills and Experience:
· The applicant must have attended medical training with a Medical Degree with relevant clinical experience plus experience in management or a Master Degree with relevant experience managing comparable units in non Government organizations.
· At least three years’ experience in medical claims management and underwriting.
· Proven Leadership skills, good interpersonal skills, and ability to enhance corporate performance
· Excellent communication, negotiation, and conflict resolution and administrative skills
· The applicant should have distinguished level of maturity and excellence in muliti-disciplinary health care management.
· ICT Competency
How to Apply:
All suitably qualified and interested candidates should send us their comprehensive applications and up-to-date CVs, copies of certificates including daytime telephone numbers via email to firstname.lastname@example.org. Your application should include three referees, none of whom should be your relative and all of whom should have supervised you, taught you or known you through work. The referees’ information should include day time telephone numbers and email addresses. Please note that only successfully candidates will be contacted.
Deadline: 16th September 2016
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