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Medical and Quality Assurance Nurse(Abuja)

3 months ago

india StreSERT Integrated Limited Full time
Job Description

Job Title: Medical and Quality Assurance Nurse

Location: Abuja

Job Responsibilities

  • Attend to and resolve all enrollees’ enquires and ensure that all complaints are promptly resolved on first call resolution, or immediately escalated to the appropriate group or unit.
  • Meticulously log all for management analysis and documentation for all relevant stakeholders.
  • Follow-up on specific cases as assigned by the line manager for measurable outcomes and stakeholders’ satisfaction.
  • Actively and proactively engage in the vetting of bills from the organization’s network of facilities providing secondary/tertiary healthcare services on the public sector social health insurance program
  • Benchmark all received claims with the pre-authorized codes given by call center as any service provided by any facility without pre-authorized code is considered null and void.
  • Review all the received bills and possibly contact the enrollees for authorization of services provided.
  • Investigate and report any incident of abuse, neglect or maltreatment of enrollees immediately to the Management for appropriate actions to be taken.
  • Follow up on enrollees on admission in order to evaluate and document their progress and possibly assist the care team with developing and accessing health interventions.
  • Participate in case management through scheduled and unscheduled visitation to enrollees on admission.
  • Graduate Professional Nurse and First Degree from an accredited Baccalaureate Nursing Program (University)
  • Must be a registered and licensed practitioner.
  • Possession of recognized additional training in primary health care and midwifery is desirable.

Experience:

  • Applicants must have minimum of 2 years’ experience as a Nurse and Midwifery Professional.
  • Ability to work seamlessly with Computer and other communication equipment and software.


Method of Application
Interested and qualified candidates should send their CVs to using QAN-ABJ-24 as subject of the mail.