Managed Care Officer (Edo)
a Growing Multi-specialist Healthcare Group - Dragnet Solutions Limited
About the Role
- To manage the day-to-day interface with assigned HMO and retainership schemes, handling enrolee verification, authorisations, referrals and claims to support smooth enrolee care and timely reimbursement.
Responsibilities
- Verify enrolee eligibility and process pre-authorisation and referral requests within scheme terms.
- Prepare, submit, track and reconcile claims, and follow up promptly on rejections and outstanding payments.
- Liaise with assigned scheme partners on authorisations, queries and disputes.
- Coordinate with clinical teams to ensure care is delivered within scheme rules and properly documented.
- Respond to enrolee enquiries and complaints, escalating as needed.
- Maintain accurate managed-care records and produce regular activity reporting.
Requirements
Education:
- A relevant First Degree or HND (e.g. Health Sciences, Nursing, Public Health, Business Administration, or a related discipline). Completion of NYSC, or a valid exemption where applicable.
Experience:
- Minimum of 4 years of relevant experience in managed care/HMO operations, health insurance or healthcare administration.
Required skills:
- Working knowledge of HMO and retainership processes, authorisations and claims.
- High attention to detail and accuracy in claims and records.
- Ability to liaise effectively with scheme partners and clinical teams.
- Effective communication and problem-solving.Competent use of relevant claims/records systems.
Application Closing Date
6th October, 2026.
How to Apply
Interested and qualified candidates should:
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Vacancy posted 5 days ago
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