About the Role
Dragnet Solutions is a dynamic Information Technology company specializing in innovative people screening solutions and recruitment processes. We are currently seeking a detail-oriented and experienced Managed Care Officer to join our team in Warri. In this role, you will manage the day-to-day interface with assigned HMO and retainership schemes, handling enrolee verification, authorisations, referrals, and claims to support smooth enrolee care and timely reimbursement.
Key Responsibilities- Verify enrolee eligibility and process pre-authorisation and referral requests within established scheme terms.
- Prepare, submit, track, and reconcile claims, while following up promptly on rejections and outstanding payments.
- Liaise effectively with assigned scheme partners regarding authorisations, queries, and disputes.
- Coordinate with clinical teams to ensure care is delivered within scheme rules and properly documented.
- Respond promptly to enrolee enquiries and complaints, escalating issues when necessary.
- Maintain accurate managed-care records and produce regular activity reports for management review.
- A relevant first degree or HND in Health Sciences, Nursing, Public Health, Business Administration, or a related discipline.
- Mandatory completion of NYSC or possession of a valid exemption certificate.
- Minimum of 4 years of relevant experience in managed care, HMO operations, health insurance, or hospital claims and billing.
- Working knowledge of HMO processes, authorisations, and claims management systems.
- Strong communication, problem-solving, and interpersonal skills with high attention to detail.
- Professional certification relevant to health insurance or managed care will be an added advantage.
- Competitive salary package commensurate with experience.
- Opportunities for professional growth and career development within a leading organization.
- Health insurance and other staff welfare benefits.
- A collaborative and dynamic work environment.