HEALTH AND WELLNESS SPECIALIST
A company specialised in Medical Scheme Administration is looking to hire an experienced and result-driven Health and Wellness Specialist to join their Client Services team. As a Health and Wellness Specialist, he/she will be responsible for facilitating wellness and the provision of efficient and effective healthcare services to the company’s clients.
JOB PURPOSE
To facilitate wellness and the provision of efficient and effective healthcare services to clients.
KEY RESPONSIBILITIES
- Develop and implement health promotion/wellness policies, organise health promotion and wellness programs for clients.
- Develop and implement quality of service monitoring and evaluation tools for Health Care Providers (HCP) and company site clinics, continuously monitor and evaluate quality of service to ensure efficient and effective services to clients/beneficiaries.
- Maintain continued communications with HCP and provide positive solutions to all inquiries and necessary pre-authorization of medical procedures and queried bills.
- Organizing and arranging emergency rescue and facilitating access to international health services and ensuring that the service is well marketed and understood by clients.
- Analysing, verifying, and validating medical claims/bills from HCP to ensure that they are complete, correct, and reasonable considering the hospital/clinic visits/stays, medical procedures performed, and agreed on price schedules to facilitate timely payments to all HCP.
- In conjunction with the System Administrator and the Client Services Executives, maintain an updated record of associated HCP and applicable medical services and pricing schedules, codes for all health services, treatments, commodities, drugs, procedures, surgeries, diagnostics; client health/medical policy documents, coverage and register of beneficiaries
- Preparing and submitting detailed and accurate periodic (monthly, quarterly andannual) reports to clients and other necessary documentation including payment details to HCP.
KEY SKILLS
- Excellent computer skills – MS Office – Word, Excel, email (essential) & Medical claims systems
- Knowledge of statistical and quantitative analysis methods
- Excellent knowledge of medical, pharmaceutical & health practices
- Ability to interact with other healthcare professionals
- Ability to maintain the confidentiality of information
- Excellent communication skills and report-writing skills
QUALIFICATIONS & EXPERIENCE
- Full Grade 12 School Certificate with at least 5 credits
- Minimum Degree/Diploma in the health/medical field
- Postgraduate qualifications in insurance or business administration
- 5 years of relevant experience preferably in the health or insurance secto
- Should be registered with the General Nursing Council of Zambia/ Health Professions Council of Zambia and in possession of a valid practicing license
PERSONAL ATTRIBUTES
- Loyalty, commitment, honesty, and integrity
- Enthusiasm, motivation, reliability, and adaptability
- Positive self-esteem and confidence
- Balanced attitude to work/home life
JOB REQUIREMENTS
- Must be prepared to work outside regular working hours.
APPLICATION REQUIREMENTS
Interested persons who meet the job requirements should email their application letter and CV to apply@jobsportal-career.com. Please note that only shortlisted candidates will be contacted. Closing date: 29th March 2023.
