MK
Minet Kenya
Care Manager – Call Centre Agent at Minet Kenya
KenyaFull TimeMid-Senior Level
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Minet Kenya
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Purpose for the Job
Duties and Responsiblities
Case management & Pre-authorization
Timely adjudication and issuance of approval letters as per policy guidelines.
Ensure that all admitted patients are visited and case management process is compliant to ISD protocol.
Management of Special Cases & Arbitration.
Management of ACOS & ALOS.
Manage local and abroad evacuations.
Cost containment
Enforcement of rates, Discount negotiations, Client Advisory, Step down management, Discharge planning, Homecare management.
Call Centre Management
Effective management of the 24-hour call Centre. Ensure seamless access to care.
Professional, accurate and timely responses to clients.
Attend to customer feedback/complaints.
Timely escalation and reporting of any incidences.
Maintain desired call drop rate.
Enhance Customer Experience
Establish and maintain good relationships with internal and external stakeholders such as Health care service providers, Insurers, Contracted providers etc.
Referral to CDM Programs
Process Management
Preparation of relevant reports
Any other duty as may be assigned by the supervisor.
Key Result Areas
The accountability areas are as follows:
Case Management visits to all Funded and insured clients.
Call Centre support - Customer service.
Cost Management / Cost containment
Customer satisfaction.
Team Cohesion.
Key Competencies
The accountability areas are as follows:
Knowledge of Insurance practice.
Outstanding Decision-making skills.
Interpersonal skills.
Strong Negotiation skills.
Report writing skills.
Knowledge And Skills Required
Clinical /Medical background & knowledge.
Data Analytics & Computer Literacy.
Time Management .
Excellent verbal and written communication skills.
Solution Oriented.
Professional and Academic Qualifications
The jobholder must possess:
Diploma in Nursing or Clinical medicine, B.Sc. Health Systems Management will be an added advantage.
2 years' experience in Health Insurance Operations.