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.