Apollo Group (Apollo Investments Limited)was an idea born from the need to harness synergies across the insurance business. Built on commitment, integrity and innovation, it has risen to be one of the leading financial groups in East Africa. Apollo Investments Limited (AIL) includes APA Insurance (Kenya and Uganda). It underwrites General Insurance risks such as Fire, Marine, Aviation, Personal Accident, Motor, Liability, Agriculture, Property, and Micro Insurance. We also underwrite Health Insurance i.e. Corporate, Individual & Family Health Insurance. APA Life Assurance is one of the leading insurance companies in Kenya providing Life Insurance and Pension benefits.It has been recognised as The Best Insurance Company in Claims Settlement (Life Business). Our Individual products, APA Elimu,Pumzisha, Imarika and HosiCare aim to protect generations as well as help people from all walks of life to meet common needs.
Employment Type:Permanent
Job Id:pdA7xFmHRX
Key Primary Responsibilities
- Accrediting high level and cost effective medical providers and negotiating on rates and discounts; Manage contracts with service providers including developing innovative reimbursement options and positioning APA as a partner to the providers.
- Maintaining proper case management principles through reviews of all pre-authorizations;
- Ensure proper mechanisms are in place for reviewing all individual proposal forms and medical reports and advising the medical underwriting on risk management and appropriate limits of cover;
- Lead the development and implementation of programs for promoting healthy lifestyle through coordination of wellness camps and health talks, distributing health publications and engaging all clients with chronic diseases to the CDM panel for better disease management;
- Implementing internal and external audit recommendations on matters related to case management and medical provider’s provisions within the agreed timelines;
- Coordinating the approval process of all overseas referrals as per the set guidelines;
- Contributing to attaining renewal retention by training scheme leaders on benefit utilization;
- Guiding the business in compliance to health regulations relating to health insurance. Comply with statutory, regulatory and internal control processes at the business units including internal and external audit recommendations;
- Developing departmental budget and business plans to achieve the set company targets;
- Entrenching performance based appraisal of departmental staff in line with their set KPIs and departmental targets;
- Participating in company CSR and brand building activities in liaison with other departments;
- Training, coaching and mentoring staff in order to improve performance and cohesion within the department;
- Implementing interdepartmental SLA in liaison with other departmental heads;
- Participating in management meetings, projects and committees as assigned.
- Develop and implement a Managed Care strategy aimed at coordinating medical care to achieve good patient experience, better treatment outcomes and reduced healthcare costs.
- Develop departmental budget and business plans to achieve the set company targets;
- Entrench performance based appraisal of departmental staff in line with their set KPIs and departmental targets;
- Participate in company CSR and brand building activities in liaison with other departments;
- Train, coach and mentor staff in order to improve performance and cohesion within the department
ACADEMIC QUALIFICATIONS
- Bachelor’s degree in relevant field eg 1st Degree in medicine/pharmacy/Nursing together with post graduate qualifications in healthcare management/health systems management/health economics/MBA
- Business Management Training
Job Skills And Requirements
- Strong leadership and management skills
- Ability to work independently and build effective interpersonal relations
- Bias towards innovation and development of new ideas in problem solving
- Professionalism in dealing with both internal and external customers
- Effective communication both written and verbal
PROFESSIONAL QUALIFICATIONS
- ACII/AIIK or
- Registered with a recognized medical professional body; Kenya Medical Practitioners and Dentists Council / Nursing Council of Kenya (NCK
EXPERIENCE
- At least 8 years’ relevant experience with 3 years’ at managerial level.
The post Manager-Care and Provider Relations at APA Life Assurance Company Ltd appeared first on Jobs in Kenya - http://jobwebkenya.com/.
The post Manager-Care and Provider Relations at APA Life Assurance Company Ltd is republished from Jobs – Jobs in Kenya – http://jobwebkenya.com/
