About the Role
Noor Health partners with leading hospitals across Nigeria, leveraging cutting-edge technology to make quality healthcare accessible to everyone. We are looking for a dedicated Case Manager to coordinate enrollee care, manage treatment plans, and ensure seamless communication between healthcare providers and enrollees.
As a Case Manager, you will serve as the primary point of contact for enrollees, ensuring they receive appropriate, timely, and cost-effective healthcare services. You will work closely with medical providers, internal teams, and enrollees to facilitate referrals, monitor treatment progress, and uphold the highest standards of care and confidentiality.
Key Responsibilities- Act as the primary point of contact for enrollees, coordinating all aspects of their care, including appointments and referrals.
- Collaborate with healthcare providers to ensure enrollees receive appropriate inpatient and outpatient care.
- Track enrollee progress and ensure adherence to care plans and treatment schedules.
- Facilitate referrals to specialists or hospitals, ensuring proper documentation and pre-authorization.
- Work with the provider relations team to ensure quality and accessibility of healthcare services.
- Educate enrollees on their health plan benefits and guide them through the referral process.
- Review and monitor medical cases regularly to assess treatment effectiveness.
- Maintain accurate and up-to-date records of enrollee medical histories, treatments, and follow-ups.
- Ensure care delivery aligns with HMO guidelines and medical necessity standards.
- Uphold strict confidentiality and comply with data protection laws and internal security policies.
- Report suspected data breaches or unauthorized access promptly.
- Participate in periodic data protection training and departmental knowledge-sharing sessions.
- Provide additional support to the Managing Director and Vice Chairman as required.
- Bachelor’s degree in Nursing, Healthcare Administration, or a related field.
- Minimum of 4 years’ experience in case management or healthcare coordination, preferably within an HMO or health insurance setting.
- Strong ability to coordinate and manage medical cases for timely, appropriate care.
- Expertise in developing and implementing effective enrollee care plans.
- Excellent communication skills for engaging providers, enrollees, and families.
- Strong problem-solving skills to resolve care-related issues across multiple stakeholders.
- Solid understanding of healthcare systems, insurance processes, and the HMO model.
- Opportunity to work with a forward-thinking healthcare technology company.
- Collaborative and supportive team environment.
- Exposure to a wide network of top hospitals and healthcare providers.
- Professional growth and development opportunities.