Hospital HMO Manager Job at Syx-Brij Nigeria Limited
Syx-Brij Nigeria Limited - Our client, Vima Hospital, is recruiting to fill the position below:
Job Position: Hospital HMO Manager
Job Location: Ikorodu, Lagos
Employment Type: Full-time
Responsibilities
HMO Liaison:
- Serve as the primary point of contact between Vima Hospital and Health Maintenance Organizations.
- Manage communication, negotiations, and relationship-building with HMO representatives.
Verification and Authorization:
- Verify patient eligibility and coverage with HMOs.
- Obtain necessary authorizations for medical procedures, tests, and treatments covered by HMO plans.
Billing and Claims:
- Ensure accurate and timely submission of patient claims to HMOs.
- Coordinate with the billing department to resolve any discrepancies or issues related to HMO billing.
Documentation and Record-Keeping:
- Maintain comprehensive and up-to-date records of HMO-related transactions, authorizations, and communications.
- Prepare reports on HMO utilization, claims, and reimbursement.
Educational Outreach:
- Educate patients on their HMO coverage, benefits, and responsibilities.
- Provide guidance on navigating HMO processes and requirements.
Conflict Resolution:
- Address and resolve any issues or disputes between Lifeshade Hospital and HMOs.
- Collaborate with internal departments to ensure compliance with HMO agreements.
Compliance:
- Stay abreast of changes in HMO policies, regulations, and industry trends.
- Ensure hospital practices align with HMO contractual agreements and regulatory requirements.
Qualifications
- Bachelor's degree in Healthcare Administration, Business Administration, or a related field can be a bonus.
- Proven experience working in a similar role within the healthcare industry.
- Detail-oriented with excellent organizational and problem-solving abilities.
- In-depth knowledge of HMO processes, policies, and regulations.
- Strong communication and negotiation skills.
- Ability to work collaboratively in a fast-paced healthcare environment.
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