Quality Assurance NurseBayelsa
Quality Assurance NurseBayelsa
Posted on :
13-03-2025
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1 Vacancy
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Job Description
Job Title: Quality Assurance Nurse (Bayelsa)
Location: Bayelsa
Job Summary
Our client is an HMO with offices across the six geopolitical zones in the country.
Job Responsibilities
- Attend to and resolve all enrollees enquires and ensure that all complaints are promptly resolved on first call resolution or immediately escalated to the appropriate group or unit.
- Meticulously log all for management analysis and documentation for all relevant stakeholders.
- Followup on specific cases as assigned by the line manager for measurable outcomes and stakeholders satisfaction.
- Actively and proactively engage in the vetting of bills from the organization s network of facilities providing secondary/tertiary healthcare services on the public sector social health insurance program
- Benchmark all received claims with the preauthorized codes given by call center as any service provided by any facility without preauthorized code is considered null and void.
- Review all the received bills and possibly contact the enrollees for authorization of services provided.
- Investigate and report any incident of abuse neglect or maltreatment of enrollees immediately to the Management for appropriate actions to be taken.
- Follow up on enrollees on admission to evaluate and document their progress and possibly assist the care team with developing and accessing health interventions.
- Participate in case management through scheduled and unscheduled visitation to enrollees on admission.
Education
- Graduate Professional Nurse and First Degree from an accredited Baccalaureate Nursing Program (University)
- Must be a registered and licensed practitioner.
- Possession of recognized additional training in primary health care and midwifery is desirable.
Experience
- Applicants must have at least 2 years experience as a Nurse and Midwifery Professional.
- Ability to work seamlessly with Computer and other communication equipment and software.
Method of Application
Employment Type
Full Time
Key Skills
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