About the Role
Dragnet Solutions is looking for a dedicated and results-driven Coordinator, Managed Care Services to lead our healthcare partner's managed-care function. In this pivotal role, you will own the interface with HMOs and retainership schemes, ensuring that enrolee service, claims, and authorization processes deliver both high-quality patient care and strong commercial sustainability.
Key Responsibilities- Direct hospital managed-care operations and cultivate strong, productive relationships with HMO and retainership partners.
- Oversee seamless enrolee verification, pre-authorizations, patient referrals, and care management within scheme terms.
- Manage claims preparation, submission, reconciliation, and follow-up to minimize rejections and processing delays.
- Monitor service-level agreements (SLAs) and lead effective dispute resolution with scheme partners.
- Collaborate closely with clinical teams to guarantee that patient care remains evidence-based, cost-effective, and compliant with scheme rules.
- Supervise, coach, and develop managed-care, clinical support, and customer experience staff.
- Track managed-care performance and revenue streams, reporting critical findings alongside actionable improvement recommendations.
- Champion a superior enrolee experience, ensuring rapid complaints resolution and high retention across the function.
- A relevant first degree in health sciences, nursing, public health, business administration, or a related discipline.
- Successful completion of the National Youth Service Corps (NYSC) or possession of a valid exemption certificate.
- Minimum of 8 years of relevant professional experience in managed care, HMO liaison, or healthcare administration, including demonstrated supervisory experience.
- Substantial expertise in health insurance operations, HMO workflows, and hospital revenue-cycle management.
- Proven track record of coordinating complex claims, authorizations, and stakeholder relationships in a healthcare setting.
- Strong proficiency in bridging clinical requirements with commercial objectives.
- Competitive salary package commensurate with experience and industry standards.
- Opportunities for professional growth and leadership development within a reputable organization.
- Comprehensive health insurance and wellness benefits.
- A collaborative, dynamic, and supportive work environment that values excellence and integrity.