Managed Care Medical Officer OND / NCE Job

Location: Abuja

Employment Type: Full-time

Job Objective

As a Managed Care Medical Officer, you will play a pivotal role in overseeing and optimizing healthcare delivery within the managed care unit.

You will collaborate with various stakeholders to ensure the effective utilization of resources while maintaining high-quality patient care standards. This position requires a combination of clinical expertise, strategic planning, and strong communication skills.

Reports to: Managed care Coordination QA&QC, Finance Director/ Administration

Direct Report: Customer service officers, nurses, doctors, pharmacy, lab, internal control.

Key Responsibilities

Clinical Oversight:

Provide medical expertise and guidance to ensure the delivery of evidence-based, high-quality care.

Review and evaluate medical necessity, appropriateness, and effectiveness of healthcare services and interventions.

Utilization Management:

Develop and implement utilization management strategies to optimize resource utilization while maintaining quality care.

Review and approve treatment plans, referrals, and requests for medical services in accordance with established guidelines and policies.

Provider Collaboration:

Collaborate with healthcare providers, including physicians, specialists, and allied health professionals, to streamline care delivery and enhance patient outcomes.

Facilitate communication and coordination among providers to ensure continuity of care and effective care transitions.

Data Analysis and Reporting:

Analyze healthcare data to identify trends, patterns, and opportunities for improvement in care delivery and cost containment.

Generate reports and metrics to track key performance indicators and outcomes related to managed care initiatives.

Quality Improvement:

Participate in quality improvement initiatives to enhance patient safety, satisfaction, and clinical outcomes.

Implement best practices and evidence-based guidelines to drive continuous improvement in healthcare delivery processes.

Compliance and Regulatory Oversight:

Ensure compliance with regulatory requirements, accreditation standards, and contractual obligations related to managed care operations.

Monitor and address issues related to documentation, coding, billing, and claims processing.

Educational Qualifications

MBBS

Registration with relevant bodies.

Required Experience

Minimum of 1 year.

Application Closing Date

15th March, 2024.

How to Apply

Interested and qualified candidates should send their CV to: hrdedahospital@gmail.com using the Job Title as the subject of the mail

DEDA Hospital is a leading Nigerian healthcare provision facility with a history of successful health outcomes for our clients. Started Operations in 2012, DeDa hospital is home to an array of experienced healthcare providers and administrators from across the world with a dedication to delivering optimal healthcare service, especially to women, children and families. For over 6 years, DeDa hospital has provided Abuja, Nigeria and the International world with high quality, compassionate healthcare.
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