![Old Mutual Kenya](https://media.trabajo.org/img/noimg.jpg)
Case Management Nurse at
2 months ago
Old Mutual Kenya is based in Nairobi and is part of a larger group that offers solutions in long-term savings, asset management and investment.
We offer solutions to individuals and corporates underpinned by our core values which are:Respect, Integrity, Accountability and Pushing beyond boundaries.
SUMMARY
To control and manage medical benefit utilization through preauthorization and case management activities and ensure quality, appropriate cost-effective care and good customer service
KEY TASKS AND RESPONSIBILITIES
Pre-authorize scheduled and non-scheduled admissions within the set guidelines.
Negotiate/discuss professional fees as appropriate for each admission.
Set the appropriate parameters for each admission (claim reserve, initial authorized cost and duration).
Visit all admitted clients within Nairobi region and its environs
Liaise with Doctors on the day-to-day management of patients and obtain medical reports/ expected length of stay where indicated.
Ensure smooth discharge process and co-ordinate any necessary post-hospitalization/ step down facility care.Revise reserves after discharge of member.
Collect feedback from admitted clients on quality and scope of service by the service provider.
Assist in carrying out verification and medical audit of claims/invoices before settlement.
Develop and maintain monthly database on admissions, large claims and extended length of stay.
Respond to queries from clients, intermediaries and service providers.
Liaise with other medical underwriter for purposes of market surveys and development of new controls, standards and products.
Any other duty assigned by management.
REQUIREMENTS
SKILLS AND COMPETENCIES
Excellent communication and negotiation skills.
Excellent public relations and interpersonal relationship skills.
Extensive networking with SP and other medical insurers.
Excellent analytical and monitoring skills
Good IT skills in database management and office systems.
Good decision making in benefit utilization management.
High levels of integrity and honesty
QUALIFICATIONS, KNOWLEDGE & EXPERIENCE
Diploma or Degree in Nursing
Diploma in Insurance/ COP
Degree in Health systems Management/ Business management
3 years' experience in clinical setting +2 years in insurance set up
-
Case Manager, Active Case Management
3 weeks ago
Nairobi, Nairobi Area, Kenya Jubilee Insurance KE Full timeABOUT THE COMPANYJubilee Insurance was established in August 1937, as the first locally incorporated Insurance Company based in Mombasa in 1937. Jubilee Insurance has spread its sphere of influence throughout the region to become the largest Composite insurer in East Africa, handling Life, Pensions, general and Medical insurance. Today, Jubilee is the number...
-
Case Management Officer
1 month ago
Nairobi, Nairobi Area, Kenya Britam Full timeABOUT THE COMPANYBritam is a leading diversified financial services group, listed on the Nairobi Securities Exchange. The group has interests across the Eastern and Southern Africa region, with operations in Kenya, Uganda, Tanzania, Rwanda, South Sudan, Mozambique and Malawi. The group offers a wide range of financial products and services in Insurance,...
-
Case Management Officer
1 month ago
Nairobi, Nairobi Area, Kenya Britam Full timeABOUT THE COMPANYBritam is a leading diversified financial services group, listed on the Nairobi Securities Exchange. The group has interests across the Eastern and Southern Africa region, with operations in Kenya, Uganda, Tanzania, Rwanda, South Sudan, Mozambique and Malawi. The group offers a wide range of financial products and services in Insurance,...
-
Case Management Officer
2 weeks ago
Nairobi, Nairobi Area, Kenya Britam Full timeBritam is a leading diversified financial services group, listed on the Nairobi Securities Exchange. The group has interests across the Eastern and Southern Africa region, with operations in Kenya, Uganda, Tanzania, Rwanda, South Sudan, Mozambique and MalawiJob Purpose:Reporting to the Assistant Manager Case & Provider Management, the role holder will be...
-
Case Management Officer
2 months ago
Nairobi, Nairobi Area, Kenya Britam Insurance Full timeABOUT THE COMPANYWe are a diversified financial group, listed on the Nairobi Securities Exchange, with interests across the Eastern Africa region. We offer a wide range of financial products and services in insurance, asset management, banking and property, with offices in Kenya, Uganda, Rwanda, South Sudan; and presence in Mozambique, Malawi and Tanzania,...
-
Case Manager at
3 months ago
Nairobi, Nairobi Area, Kenya Beacon of Hope Vocational Training College Full timeBeacon Of Hope- is a registered Faith based and community non-governmental OrganisationPosition Summary:This position contributes to SEE goal "Transformed individuals, families and communities through spiritual, physical, economic and social empowerment who embrace progressive values, and engage in productive, gainful and sustainable activities''.Key...
-
Technical Advisor- Case Management, REACH Malaria at
2 months ago
Nairobi, Nairobi Area, Kenya PATH Full timePATH is an international organization that drives transformative innovation to save lives and improve health, especially among women and children.Roles and Responsibilities:Provide overall technical guidance and leadership for implementation of Malaria Case Management Activities. Provide leadership for Quality Assurance and Quality Improvement Measures in...
-
paediatric nurse
3 months ago
Nairobi, Nairobi Area, Kenya Brites Management Full timeJOB TITLEPAEDIATRIC NURSENATURE OF JOBFULL TIMEINSTITUTIONSCHOOLSALARYKshs. 60,000.00-Kshs 80,000.00JOB LOCATIONNAIROBI DUTIES AND RESPONSIBILITIESTo provide care to students and staff who need general treatment, emergency care due to injury or who present with an acute illnessUnderstand each students medical backgroundAdminister medication and deliver...
-
Nurse at
3 months ago
Nairobi, Nairobi Area, Kenya KCA University (KCAU) Full timeKCA University (KCAU) is a private, non-profit institution, founded in July 1989 as Kenya College of Accountancy (KCA) by the Institute of Certified Public Accountants of Kenya (ICPAK) to improve the quality of accountancy and financial management training in the country. KCAU is located on Thika Road in Ruaraka, Nairobi, KenyaJOB OBJECTIVEThe job holder...
-
Nurse
4 weeks ago
Nairobi, Nairobi Area, Kenya Penda Health Full timeABOUT THE COMPANYPenda Health is an award winning company that is transforming healthcare in Kenya by building a chain of outpatient health clinics that offer evidence-based medical care and unparalleled patient experience at surprisingly affordable rates.JOB SUMMARYKey requirements and attributes Diploma in Nursing - KRCHN holding a valid practicing license...
-
Research Nurse at
1 month ago
Nairobi, Nairobi Area, Kenya Kenya Medical Research Institute - KEMRI Full timeKenya Medical Research Institute (KEMRI) is a State Corporation established through the Science and Technology (Amendment) Act of 1979, which has since been amended to Science, Technology and Innovation Act 2013Key Responsibilities:Support, facilitate, and coordinate the daily activities of research projects ongoing within the SWOP clinics; Reviews and...
-
Theatre Nurses at
1 month ago
Nairobi, Nairobi Area, Kenya M.P. Shah Hospital Full timeM.P. Shah Hospital is a modern 210-bed facility which is home to highly skilled and experienced specialists and professional medical staff.Duties & Responsibilities:Patient care- Provide holistic patient care, including physical, mental, and social wellbeing Respond to emergencies – Instantly respond to medical emergency and immediately alerting the senior...
-
Theatre Nurse at
4 weeks ago
Nairobi, Nairobi Area, Kenya Ruaraka Uhai Neema Hospital Full timeRuaraka Uhai Neema Hospital (RUNH) is proving every single day that it is possible to deliver healthcare to all with quality and commitment. RUNH was founded by World Friends in partnership with the Catholic Archdiocese of Nairobi and CISP and has been offering quality healthcare at affordable prices to our Nairobi communities since 2009Job Responsibilities...
-
Theatre Nurse at
3 months ago
Nairobi, Nairobi Area, Kenya Avenue Healthcare Full timeAvenue Hospital was founded in 1995 for the purpose of managing the outpatient department at the Hospital, and to extend medical services to corporate clientele through an innovative concept of Managed Healthcare.PurposeAdhere to Avenue Healthcare's defined policies, protocols, procedures and standards.Key Responsibilities Maintaining Theatre list Correctly...
-
Locum Flight Nurse at
4 weeks ago
Nairobi, Nairobi Area, Kenya AMREF Flying Doctors Full timeAMREF Flying Doctors is the leading provider of fixed – wing air ambulance services in Africa. We have been in the aeromedical transport industry for more than 60 years – operating from Wilson Airport in Nairobi.OVERALL RESPONSIBILITY OF THE JOB The Locum Flight Nurse is charged with rendering skilled pre-hospital and emergency life support care to the...
-
Nurse at
2 months ago
Nairobi, Nairobi Area, Kenya Ubuntu Life Full timeThe Ubuntu Life mission is 'Connect to Empower.' When we first came to Maai Mahiu, Kenya, we found a community of children with special needs and their mothers being mistreated and secluded. The stigma and lack of understanding surrounding special needs in Kenya means extremely limited access to essential services such as education, affordable healthcare,...
-
Director of Nursing
3 months ago
Nairobi, Nairobi Area, Kenya Africa Healthcare Network Full timeAfrica Healthcare Network has established the first and largest dialysis chain across Sub-Saharan Africa, providing high-quality, life-saving dialysis at affordable cost.SummaryAHN is looking for a highly skilled and dedicated team member for the role of Director of Nursing. In this position, the Director of Nursing is responsible for hiring standards and...
-
Chief Nursing Officer
2 months ago
Nairobi, Nairobi Area, Kenya Veteran Mission Hospital Full timeVeteran Mission Hospitals Limited was born from the identification of the presence of a huge gap in the medical industry which is between what the people need and what is available in the industry.Job Summary:The Chief Nursing Officer (CNO) plays a pivotal role in leading and managing the nursing department at Veteran Mission Hospital. As a key member of the...
-
Clinical Nurse
4 months ago
Nairobi, Nairobi Area, Kenya Corporate Staffing Services Full timeNursing positions available at Aga Khan University Hospital in Nairobi, a leading private teaching hospital offering top-notch healthcare services. The hospital, accredited by the Joint Commission International, has been delivering exceptional care to the East African community for over six decades.The successful candidate will directly report to the Nurse...
-
NICU Nurse
3 weeks ago
Nairobi, Nairobi Area, Kenya Avenue Healthcare Full timeAvenue Hospital was founded in 1995 for the purpose of managing the outpatient department at the Hospital, and to extend medical services to corporate clientele through an innovative concept of Managed Healthcare.Job Objective/PurposeAdhere to Avenue Healthcare's defined policies, protocols, procedures, and standards.Key Responsibilities Ensure proper...