Managed Care Medical Officer OND / NCE Job
2024-03-07 14:33 Medical / Healthcare Abuja 214 viewsJob Details
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
Company Description
We are recruiting to fill the following positions below: