Care Associate Analyst

3 days ago

Nairobi, Nairobi Area, Kenya Cigna Healthcare Full time 900,000 - 1,200,000 per year

MAJOR RESPONSIBILITIES

  • Part of a clinical team that provides medical management services to customers worldwide but mainly in Africa region.
  • Give evidence-based advice on pre-authorization, considering internationally accepted protocols and local and/or regional customs and regulations.
  • Assessing pre-authorization requests claims in line with the policy coverage and medical necessity. 
  • Identify and refer cases to the Cigna Clinical team for case management, disease management and other clinical services 
  • Assist and support the team in cost containment, assist in projects and service delivery to meet goals. 
  • To assist queries from providers and payers via phone calls or e-mails 
  • Be fully versed with medical insurance policies for various groups / beneficiaries. 
  • Might be required to assist in training colleagues and sharing knowledge. 
  • Ability to review, investigate, and respond to external and internal inquires/complaints and provide guidance to other clinical and non-clinical staff related to medical necessity. 
  • Assist in fraud detection
  • Meeting the defined qualitative and quantitative key performance metrics for the assigned job role. 
  • Ensure adherence to the predefined TATs for pre-approvals 
  • Achieving required targets assigned by the team leader on daily, weekly, and monthly basis. 
  • Ensure compliance to any changes in terms of system parameters or process. 
  • Other duties as assigned

REQUIREMENTS

  • University Degree or Diploma in Medical specialization . 
  • 2-3 years of clinical experience preferable in a payer setting on medical management.
  • Experience in the Africa region & International market
  • Fluent in English along with either French, Portuguese or Spanish, any other language is a plus
  • Strong interpersonal and communication skills. 
  • Must be a computer literate
  • Knowledge of utilization, cost containment services, insurance coverage.
  • Ability to build solid working relationships with staff, clients, customers, and healthcare providers. 
  • Demonstrates pro-active problem-solving and analytical skills 
  • Ability to work under pressure and meet tight deadlines 
  • Flexible to work on shifts/varying work schedules.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.

  • Investment Analyst and Associate

    3 days ago

    Nairobi, Nairobi Area, Kenya CrossBoundary Full time 1,200,000 - 2,400,000 per year

    Investment Analyst and AssociateCrossBoundary EnergyAbout the FirmCrossBoundary Energy develops, owns, and operates distributed renewable energy solutions for businesses, offering cheaper and cleaner energy through power purchase and lease agreements. With a secured portfolio exceeding US$710M, the company boasts over 500MW of solar PV and wind generation,...

  • Data Analyst

    2 weeks ago

    Nairobi, Nairobi Area, Kenya Koena Technology LTD Full time $104,000 - $130,878 per year

    About the RoleWe're looking for a Data Analyst & Integrations Associate to join our growing Analytics team. You'll work directly with the IT, CRM, and Analytics Manager to manage data flows, support analytics and reporting, and ensure real-time integration with external platform providers.This role sits at the intersection of data science, systems...

  • ICT Analyst

    1 week ago

    Nairobi, Nairobi Area, Kenya International Fund for Agricultural Development (IFAD) Full time 900,000 - 1,200,000 per year

    This job is based in Rome, Italy.Organizational SettingThe International Fund for Agricultural Development (IFAD) is an international financial institution and a specialized United Nations agency dedicated to eradicating rural poverty and hunger. It does so by investing in rural people. IFAD finances programmes and projects that increase agricultural...

  • BI Analyst

    1 week ago

    Nairobi, Nairobi Area, Kenya SunCulture Full time 600,000 - 1,200,000 per year

    Position: BI AnalystReporting to: Head of DataLocation: Nairobi, KenyaRole type: Full-timeAbout SunCultureFounded in 2012, SunCulture's Vision is to build a world where people take control of their environment in rewarding and sustainable ways. SunCulture does this by developing and commercializing life changing technology that solves the biggest daily...

  • BI Analyst

    1 week ago

    Nairobi, Nairobi Area, Kenya SunCulture Kenya Limited Full time 900,000 - 1,200,000 per year

    Position: BI AnalystReporting to: Head of DataLocation: Nairobi, KenyaRole type: Full-timeAbout SunCulture:Founded in 2012, SunCulture's Vision is to build a world where people take control of their environment in rewarding and sustainable ways. SunCulture does this by developing and commercializing life changing technology that solves the biggest daily...

  • Communications Associate

    1 week ago

    Nairobi, Nairobi Area, Kenya IPPF Africa Region Full time 900,000 - 1,200,000 per year

    Role Purpose:The Communications Associate will support the FON and J4S teams, the grantee partners and the Consortium partners to implement the FON and J4S Communication Plans, making sure the FON Project and IPPFAR give visibility to African grantee partners.The Communication Associate will work closely with the FON and J4S teams (based in Cotonou and...

  • Fraud & Risk Analyst

    22 hours ago

    Nairobi, Nairobi Area, Kenya Sportserve Full time 900,000 - 1,200,000 per year

    Sportserve forms part of a remarkable group of B2C sports betting and B2B sportsbook technology companies, focused on delivering first class sports betting experiences and casino products for our users worldwide. Along with Sportion, TechSpirit, Standard Focus and Sportelligent, we are the driving force behind the world renowned sports betting company and...

  • Battery Network Operations Analyst

    1 week ago

    Nairobi, Nairobi Area, Kenya Kofa Full time 900,000 - 1,200,000 per year

    Job Overview:Kofa is seeking a Battery Network Operations Analyst to join our operations team. This role is central to ensuring that our growing battery network remains reliable, efficient, and customer-focused while supporting the development of AI-driven automation and next-generation energy solutions.Key Responsibilities:Battery Network Operations...

  • Finance Associate

    1 week ago

    Nairobi, Nairobi Area, Kenya SunCulture Kenya Limited Full time 1,200,000 - 2,400,000 per year

    Department: Finance Position: Finance AssociateReporting to: Finance ManagerTenure: Full Time About SunCultureFounded in 2012, SunCulture's Vision is to build a world where people take control of their environment in rewarding and sustainable ways. SunCulture does this by developing and commercialising life changing technology that solves the biggest daily...

  • Procurement Operations Analyst

    3 days ago

    Nairobi, Nairobi Area, Kenya PZ Cussons Full time 900,000 - 1,200,000 per year

    We are PZ Cussons. Our purpose isFor everyone, for life, for good.Sustainability and the wellbeing of people, families and communities everywhere are at the heart of everything that we do.Since our founding in 1884, we have been creating products to delight, care for and nourish consumers. Across our core categories of Hygiene, Baby and Beauty, our trusted...