Head, Medical & Quality Assurance Department at a Leading NHIS Accredited National Health Maintenance Organization

A reputable dynamic and leading NHIS accredited National Health Maintenance Organization with its Headquarters situated in Abuja is in need of the services of a result oriented, proactive, knowledgeable and diligent individual to fill the position below:

Job Title: Head, Medical & Quality Assurance Department

Location: Abuja

Background

• We are looking for an experienced Medical Doctor with strong administrative skills to Manage and run our Medical and Quality Assurance Department.
• To be successfulin this role, you should have a deep understanding of all administrative process and procedure relating to the role, from developing work schedules and actively engaged/ coordinating the establishment of robust working relationship with providers and enrollees.
• He or She coordinate the budgeting, stocking and maintaining supplies of medications for our managed first aid and emergency programme.  The candidate is expected to possess   considerable knowledge of Managed Care and Health Insurance Programme.
• The candidate is expected to deploy outstanding organizational and leadership skills to drive the process and supervise/coordinate the workforce in the Department at the Head Office and across the branches for measurable performance and compliance with policies and regulations.

Duties and Responsibilities

• Coordinate and supervise the activities of the Department to ensure optimal performance;
• Ensure the smooth operation of the organization’s Telemedicine Platform.
• Monitor the activities of the Claims Unit, Providers Network Administration Unit, the Medical and Quality Assurance Department across the branches as well as the Utilization Management Unitfor quality vetting and time management in the Claims vetting process and elimination of fraud.
• Oversee thesupplies and management of medications for our first aid / emergency services across the nation.  
• Maintains a cordial working relationship among team members through effect disseminationof information, timely response to issues from critical stakeholders, buildingbridges and participating in team crisis management methods.
• Coordinate and oversee standard filing processand recordskeeping as it relates to all the activities in the Department.
• Review all pre-authorization approvals given by the Utilization Management Officers in the Call Center to ensure the genuineness of all approvals.
• Ensuresquality health care delivery to enrolees by continuous monitoring and evaluation of healthcare facilities activities.

Qualifications and Experience
Education:

• Applicant must possess a Medical Degree (MBBS)
• Up-to-date registration and license from the MDCN
• Post-Graduate Medical and Dental qualification, Certification by WACP or equivalent body or Specialist training in a chosen area of medicine are added advantages.

Experience:

• Applicant must have minimum of between 10 to 12-years Post NYSC experience.
• Minimum of 5 years’ experience working in a similar role.
• Experience in the usage of computers and other relevant software packages is desirable.

Language Requirements:

• Fluency in Oral and written English is a requirement.

Application Closing Date
27th November, 2020.

Method of Application
Interested and qualified candidates should forward their Application Letter and Resume in one document to: [email protected] using the "Job Title" as the subject of the email.