About the Role
Dragnet Solutions is a leading information technology company specializing in innovative people screening and recruitment solutions in Nigeria. We are currently recruiting a dedicated Coordinator, Managed Care Services on behalf of our client in Kaduna. In this vital role, you will lead the hospital's managed-care function, owning the interface with Health Maintenance Organizations (HMOs) and retainership schemes to ensure high-quality patient care and strong financial performance.
Key Responsibilities- Direct day-to-day managed-care operations and build robust relationships with HMO and corporate retainership partners.
- Oversee enrolee verification, pre-authorisation, referrals, and care management in strict compliance with scheme terms.
- Manage end-to-end claims preparation, submission, reconciliation, and follow-up to minimize rejections and revenue delays.
- Monitor service-level agreements and lead the prompt resolution of disputes with scheme partners.
- Collaborate with clinical teams to guarantee that patient care remains evidence-based, cost-effective, and aligned with scheme regulations.
- Supervise, mentor, and develop managed-care, clinical support, and customer experience personnel.
- Track managed-care metrics and revenue performance, providing actionable insights and improvement recommendations to management.
- Champion a superior enrolee experience, ensuring efficient complaints resolution and high retention rates.
- Possession of a relevant first degree in Health Sciences, Nursing, Public Health, Business Administration, or a related discipline.
- Mandatory completion of the National Youth Service Corps (NYSC) or presentation of a valid exemption certificate.
- Minimum of 8 years of relevant professional experience in managed care, HMO liaison, health insurance, or hospital administration.
- Demonstrated expertise in supervising teams and managing healthcare revenue-cycle operations.
- Strong proficiency in claims management, authorization workflows, and managed-care software systems.
- Exceptional communication, negotiation, leadership, and analytical skills.
- Competitive salary and performance-based incentives.
- Comprehensive health insurance and medical benefits.
- Opportunities for professional development and career advancement in a supportive work environment.