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Job Ref. No. JHIL002
Position: Manager, Medical Outcomes & Care Management
We currently have an exciting career opportunity for Manager – Medical Outcomes & Care Management, Jubilee Health Insurance Limited. The position holder will report to the Head of Clinical Operations and will be based at
Head Office, Nairobi.
Role Purpose
The job holder will manage collection and analysis of the company’s clinical outcomes data, in order to develop cost effective clinical process improvement initiatives.
Main Responsibilities
1. In depth review of clinical outcomes data in view of developing strategic initiatives that will aim to ensure our clients
receive cost effective and high–quality clinical care.
2. Sharing feedback with providers on their outcomes metrics and follow– through to develop cost effective and
sustainable solutions.
3. Monitoring of providers’ clinical care practice and ensure it is aligned to the company’s standards and prevailing
board regulations.
4. Develop a preferred provider panel based on outcomes metrics.
5. Develop algorithms of the top ailments and ensure coding in the core system.
6. Develop Jubilee Health Insurance Rate Card, Drug Formulary and ensure its coded in the Core system and
disseminated to the relevant stakeholders.
7. Monitoring disease patterns at a country, continental, and a global level in view of giving recommendations on how
to curb and control its spread.
8. Monitoring clients claiming patterns and recommending holistic solutions.
9. Participation in client’s service meeting in view of offering holistic promotive, preventative, curative and
rehabilitative medical solutions.
10. Support care management team in their day–to–day service delivery.
11. Prepare statistical reports, narrative reports, or graphic presentations on Medical Outcomes such as maternity– C/S
rate, diseases patterns, outbreaks for both internal and external clients for rebuttal action.
Key Competencies
1. Entrepreneurial Spirit
2. Market Awareness
3. Customer Focus
4. Continuous Innovation
5. Ownership & Commitment
6. Team Spirit
7. Visionary Leadership
Qualifications
1. Bachelor of Medicine & Bachelor of Surgery or any other related field.
2. Basic Understanding of the Concepts of Insurance
3. Proficient in the use of Microsoft office suite and packages
Relevant Experience
Minimum of 2 years’ experience within the clinical practice. Experience in managing health plans and medical providers.
Knowledge and Experience in the insurance industry.
If you are qualified and seeking an exciting new challenge, please apply via Recruitment@jubileekenya.com quoting the Job Reference Number and Position by 13th September 2021.
Only shortlisted candidates will be contacted.
https://jubileeinsurance.com/ke/careers/
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