Job Title: Quality Assurance Manager – (A Medical Doctor)
Industry: Health Insurance
Location: Gbagada, Lagos
•Ensure clients (corporate customers, retails customers, distribution partners and providers) have a seamless encounter with using Phillips HMO service.
• Obtain client information by answering telephone calls; interviewing clients; verifying information.
• Respond to all Enrollee and Provider inquiries and handle any complaints.
• Provide information about company products and services.
• Receive and handle customer complaints
• Seek resolution of customer queries.
• Have the most up to date information on all plans of Phillips HMO and be able to help customers in a quick and friendly fashion.
• Maintain and improve quality results by adhering to standards and guidelines
• Interact regularly with clients to obtain feedback on services
• Developing long term relationships with existing customers and ensuring their satisfaction.
• Acquire a thorough understanding of key customer needs and requirements.
• Expand the relationships with existing customers by continuously proposing solutions that meet their objectives.
• Serve as the link of communication between key customers and internal teams.
• Share regular reports of progress, forecasts, and competitor activity at customer sites.
• Work with team to bring creative solutions to customers
• Conduct regular visits to key accounts and negotiating pricing and service agreements as needed
• Implement Customer Relationship Management tools and processes.
• Contribute to the company’s business growth by increasing sales to existing accounts.
• Maintain consistent and frequent review of issue resolution metrics required to effectively manage customer service department’s operational performance, including call grading
• Work on existing or new business development opportunities.
• Referral management.
• Carry out Utilisation Management and utilization data reporting (eg monthly
medical utilization statistics)
• Participate in Provider credentialing / accreditation and provider Quality
• Carry out Case Management
• Participate in Anti-fraud and Claims investigations
• Participate in the organization of prevention and wellness programs.
• Manage relationships with providers.
• Other duties as assigned.
Experience Dimension: 5 Years above – in clinical management, physician…
Qualifications: MBBS of MBCHB (A Medical Doctor).
MBA or MPH will be an added advantage
Professional Certification in Healthcare Quality Management will be an added advantage
To Apply, Qualified candidates should please send their CVs to firstname.lastname@example.org with “QAMD” as the subject of the mail