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.
We are recruiting to fill the position below:
Job Title: Managed Care Medical Officer
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
Application Closing Date
15th March, 2024.
How to Apply
Interested and qualified candidates should send their CV to: [email protected] using the Job Title as the subject of the mail.
https://www.hotnigerianjobs.com/hotjobs/601793/managed-care-medical-officer-at-deda-hospital.html