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Quality Assurance Manager Job at Phillips HMO

Phillips HMO as a service company combines the principles of Insurance and Health Management to provide prepaid, comprehensive, qualitative, and affordable health care services through a network of efficient Health Care Providers. Incorporated on 5th April 2019, we are a corporate organization and a member of the Phillips Consulting Group a leading business and management consulting firm, serving clients across Africa. Whilst staying true to our roots, we remain globally focused on our reputation as the Phillips brand which includes maintaining/upholding its integrity as a leading provider of qualitative transformation, Health and Technology


With a rich collection of highly skilled and experienced professional and an overwhelming culture of excellence, we help solve the problem of access to quality healthcare through partnership with quality providers across Nigeria preventing individuals and families from catastrophic health expenditure. From our operational based in Lagos, we have a 24-hour state of the art call center with multiple call channels and a good IT driven process that guarantees easy enrollment and seamless access to care.

We are recruiting to fill the position below:

Job Position: Quality Assurance Manager

Job Location: Gbagada, Lagos
Employment Type: Full-time

Job Description

  • Maintain consistent and frequent review of issue resolution metrics required to effectively manage customer service department’s operational performance, including call grading.
  • Referral management.
  • Carry out Utilization Management and utilization data reporting (e.g. monthly medical utilization statistics)
  • Participate in the organization of prevention and wellness programs.
  • Participate in Provider credentialing / accreditation and provider Quality Assurance activities.
  • Carry out Case Management.
  • Participate in Anti-fraud and Claims investigations.
  • Manage relationships with providers.
  • Other duties as assigned.

Requirements

  • Qualifications: MBBS or MBCHB (A Medical Doctor), MBA or MPH will be an added advantage.
  • Experience Dimension: 1 - 2 years of post-NYSC or above.
  • HMO experience and certification in Healthcare Quality Management will be an added advantage.

Method of Application
Interested and qualified candidates should forward their CV to: recruitment@phillipshmo.net using "QAMD" as the subject of the mail.





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