Care Officer

Company Details
Industry: Banking
Description: CIC Insurance Group Limited, commonly referred to as CIC Group, is an insurance and investment group that operates mainly in Kenya, Uganda, South Sudan and Malawi
Job Details
Job Type: Full Time
Workplace Type: On-site
Qualification: Diploma
Job Experience: Mandatory
Job Location: Nairobi County, Kenya
Closing Date: Undisclosed
Salary: Undisclosed
Other Pay: Benefits
Job Category: Insurance
Job Description

About the Role

Responsible for care facilitation/cost containment and call centre reachability.

Key Responsibilities

  • Issuance of approval to insured members seeking both inpatient and outpatient care as per policy guidelines.
  • Monitor cost, average length of stay on inpatient cases.
  • Issue guidance on Pre-authorized optical, dental and scheduled procedures
  • Conduct Hospital visits whenever the insured members are hospitalized
  • Respond to stakeholder inquiries on cases involving medical care management.
  • Receive and respond to Medical emergency lines and ensure 24-hour coverage
  • Negotiate for discounts from doctors and hospitals on specific cases and procedures from time to time
  • Facilitate referrals and medical evacuations when need be.
  • Monitor benefits utilization and share timely updates to the stakeholders.
  • Prepare and share timely reports as may be guided.

Who We’re Looking For

Essential Knowledge/Skills and Experience Required:

  • Diploma in Nursing or Clinical Medicine
  • Minimum of 2 years of experience in care management, medical claims and Call Centre
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