Other · Contract
Direct employerConsultant Care Management

Published by employer
About this role
This plain-English summary was prepared by work.ke from the original advert. Confirm all details on the source before applying.
Role overview
Zamara, a financial services company based in Nairobi, Kenya, is hiring a Consultant Care Management on contract. This role suits candidates with a background in nursing or clinical medicine who have experience in hospitals or medical insurance care and are interested in client support and care management.
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What you will do
- Answer calls on the 24-hour medical emergencies helpline.
- Facilitate approvals and authorisations for emergency inpatient hospitalisation and outpatient treatments.
- Manage evacuation processes to ensure good outcomes and reasonable charges for clients.
- Process preauthorisation requests and hospital procedure bookings, including maternity and theatre procedures.
- Liaise with insurance companies during pre-authorisation processes.
- Manage provider panels to ensure facilities are onboarded and maintain good relationships.
- Advocate for clients and negotiate borderline claims.
- Support overseas referrals and provide dedicated client services at their premises.
- Provide data reports from monitoring tools and conduct trend analysis on hospital charges and package costs.
- Facilitate patient admission and discharge processes by securing necessary documents and minimising patient involvement.
- Arrange special care for admitted patients, such as haircuts or flowers.
- Issue Zamara gift packs to admitted patients.
Requirements
- Hold a Diploma in Nursing Sciences or Clinical Medicine.
- Have at least one year of experience working in a hospital, health facility, or medical insurance care department.
- General understanding of the insurance industry is preferred.
- Ability to build relationships.
- Possess business etiquette.
- Have excellent interpersonal and customer service skills.
- Be a team player.
- Have problem-solving skills.
- Be self-driven.
- Be flexible and willing to train.
How to apply
Apply through the employer's official contact by submitting the required documents before the closing date. The employer has not published a closing date.