Job Title: 2 Care Managers
Organization: Jubilee Health Insurance Company
Location: Kampala
Roles and responsibilities
- Review medical claims for compliance with applicable policy guidelines
- Interact with clients, brokers and clinicians to resolve problems with principals of the policy.
- Obtain medical information from providers during initial contact, visits and follow up with written correspondence if necessary.
- Participate in care management meetings.
- During claim approval and second checking, confirm and ensure that accurate claim details are captured from the claim documents into ACTISURE by registrars.
- Check and confirm membership validity and benefits (from the scheme benefits file),handling of coverage enquiries with brokers, providers, members etc.
Vet and confirm validity of the service given by the service provider in relation to the benefits covered, treatment given, adherence to provider panel rules and cost of treatment. - Help in obtaining additional required information on claims from providers.
- Check and confirm any advice by the registrar on any relevant information noted on claims during claim approval or second checking.
- Liaising with the underwriting team on scope of cover for various schemes.
- Pre-authorize services that require prior approval from Jubilee Health.
- Manage 24-hour emergency help line.
- Any other duties that may be assigned by the Line Manager/ supervisor from time to time.
Minimum Qualifications:
- Degree / Diploma in Clinical studies / Medical Course or any related course.
- Good understanding of the concepts of medical insurance
- Minimum of Two (2) years’ experience.
How to apply
Suitably qualified candidates should address their application, CV and photocopies of academic testimonials to the email below;
jhicu-recruitment@jubileeuganda.com
Application deadline: 20th March, 2023.
Only shortlisted candidates will be contacted for interviews.
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