Care Team Nurse GA Insurance Uganda

Position: Care Team Nurse

Responsibilities:

• Pre-authorization of scheduled

and non-scheduled admissions to ensure

validity, legitimacy of admission, and advice on cover

• Liaise with physicians to obtain client medical reports to ensure they are getting optimal, quality care at most
• Negotiate professional fees for each admission to ensure clients are receiving cost effective care within the scope of their cover
• Discount negotiations with the doctors on procedure charges and consultation
• Manage the 24-hour helpline and ensure client enquiries are sorted to satisfaction and assist with medical emergencies
• Visit all admitted clients as part of company PR and to ensure the clients are getting appropriate satisfactory services
• Attend to preauthorization email requests promptly
• Co-ordination of inter-hospital transfers, medical evacuation, step down care, home care and nursing, care upgrade as when required as per clinical assessment
• Be the first contact to service providers on disputes from client’s complaints about GA Insurance
• Audit existing providers to ensure that protocol is adhered to (if not adhered to, make recommendation on next action-suspend/terminate/warning.)
• Train providers on GA protocols to maintain standards
• Maintain Service Providers contacts and undated
• Maintain report on Service Providers visits and issues
• Maintain relationship with existing/new/potential Service Providers
• Renegotiation of terms with existing Service Providers within set GA insurance guidelines; make recommendations for changing terms outside the job’s

Minimum Qualifications:

• 2 years relevant experience
• A diploma in Nursing
• A Certificate in Insurance is added advantage
• Must be a registered and licensed Nurse with the Uganda Nurses and Midwives Council

Required Skills

• Good negotiation and influencing skills.
• Strong networking and relationship skills.
• Excellent interpersonal, verbal and communication skills.
• Demonstrate a high degree of confidentiality and attention to detail