Dragnet Solutions Limited - Our client, a reputable multi-specialist hospital, is recruiting to fill the position below:
Job Title: Coordinator, Managed Care Services
Location: Abuja
About the role
- A reputable multi-specialist hospital in Nigeria is recruiting for the role of Coordinator, Managed Care Services.
- The role involves leading the hospital's managed-care function, managing relationships with HMOs and retainership schemes, and ensuring optimal enrolee service, claims and authorization processes that deliver both quality care and commercial sustainability.
- The role reports to the Chief Medical Officer or relevant management lead and includes responsibilities such as overseeing managed-care operations, coordinating with clinical teams, and supervising staff.
Responsibilities
- Direct the hospital's managed-care operations and manage relationships with HMO and retainership partners.
- Oversee enrolee verification, pre-authorisation, referrals and management of care within scheme terms.
- Oversee claims preparation, submission, reconciliation and follow-up to minimize rejections and delays.
- Monitor service-level agreements and lead resolution of disputes with scheme partners.
- Coordinate with clinical teams to ensure care is evidence-based, cost-effective and within scheme rules.
- Supervise, coach and develop managed-care, clinical support and customer experience staff.
- Track managed-care performance and revenue, and report findings with improvement recommendations.
- Champion enrolee experience, complaints resolution and retention across the function.
Requirements
Experience:
- Minimum of 8 years of relevant experience in managed care, HMO liaison or healthcare administration, including supervisory experience.
- Substantial experience in managed care, health insurance, HMO operations or hospital revenue-cycle management.
- Experience coordinating claims, authorisations and HMO/scheme relationships. Experience supervising staff and managing service performance.
Education:
- A relevant first degree (e.g. health sciences, nursing, public health, business administration, or a related discipline). Completion of NYSC, or a valid exemption where applicable.
Required skills
- Strong knowledge of managed-care, HMO and retainership processes.
- Understanding of claims, authorisation and revenue-cycle management.
- Ability to align clinical and commercial requirements.
- Ability to lead, coach and develop a team.Strong communication, negotiation and analytical skills.
- Working knowledge of managed-care/claims systems and performance reporting.
Application Closing Date
2nd August, 2026.
https://www.hotnigerianjobs.com/hotjobs/931421/coordinator-managed-care-services-at-a-reputable-m.html