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Latest Job: Managed Care Medical Officer at DEDA Hospital

301251513

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    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 …

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    Managed Care Medical Officer

    • Job Type Full Time
    • Qualification Others
    • Experience 1 – 2 years
    • Location Abuja
    • Job Field Medical / Healthcare&nbsp

    Position Overview: 

    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

    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 QUALIFICATION

    •  MBBS
    • Registration with relevant bodies.   

    Method of Application

    Interested and qualified candidates should forward their CV to: [email protected] using the position as subject of email.

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