About the Role
Dragnet Solutions is a dynamic Information Technology company specializing in innovative people screening solutions and recruitment process management. Since 2007, we have been at the forefront of creating objective recruitment processes to meet international standards as official e-resourcing partners to major industry bodies. We are currently seeking a dedicated and experienced Coordinator for Managed Care Services to lead our managed-care function, owning the interface with HMOs and retainership schemes while ensuring enrolee service and commercial sustainability.
Key Responsibilities- Direct the hospital's managed-care operations and manage relationships with HMO and retainership partners.
- Oversee enrolee verification, pre-authorisation, referrals, and management of care within scheme terms.
- Oversee claims preparation, submission, reconciliation, and follow-up to minimise rejections and delays.
- Monitor service-level agreements and lead the resolution of disputes with scheme partners.
- Coordinate with clinical teams to ensure care is evidence-based, cost-effective, and within scheme rules.
- Supervise, coach, and develop managed-care, clinical support, and customer experience staff.
- Track managed-care performance and revenue, reporting findings with actionable improvement recommendations.
- Champion enrolee experience, complaints resolution, and retention across the function.
- A relevant first degree in health sciences, nursing, public health, business administration, or a related discipline.
- Successful completion of NYSC or possession of a valid exemption certificate.
- Minimum of 8 years of relevant experience in managed care, HMO liaison, or healthcare administration, including supervisory experience.
- Strong knowledge of managed-care, HMO, and retainership processes with excellent claims and revenue-cycle management skills.
- Proven ability to align clinical and commercial requirements while leading and developing high-performing teams.
- Exceptional communication, negotiation, and analytical skills with working knowledge of managed-care systems.
- Competitive salary package commensurate with experience and industry standards.
- Opportunities for professional growth and career advancement within a leading organisation.
- Comprehensive health insurance and wellness benefits.
- A collaborative, dynamic, and supportive work environment that values integrity and excellence.