Care Navigator – Jubilee Health Insurance

Role Purpose
The Care Navigator will provide professional guidance to assigned members and schemes, ensuring quality and cost-effective healthcare services while addressing policy matters. The role involves collaboration with providers, clients, and brokers, focusing on effective service provision and timely resolution of concerns.

Key Responsibilities

1. Strategy Development

• Identify improvement areas and propose strategies to enhance program effectiveness.

• Stay updated on healthcare regulations and policies affecting clients' access to care.

• Contribute to developing insurance policies aligned with care navigation goals.

• Analyze healthcare utilization data to identify trends and inform strategic decisions.

2. Operational Management

• Monitor healthcare-seeking behaviors and implement population health measures.

• Enroll members in Wellness Programs and monitor scheme utilization.

• Conduct health education sessions for members of assigned schemes.

• Oversee patient admissions, ensure proper care, and liaise with healthcare providers.

• Advise clients on medical conditions and direct them to suitable service providers.

• Verify service validity, ensure protocol adherence, and resolve policy-related concerns.

3. Corporate Governance

• Uphold ethical standards in all client, provider, and colleague interactions.

• Maintain compliance with healthcare laws, regulations, and insurance policies.

• Keep accurate records of client interactions and ensure confidentiality.

• Mitigate risks associated with care navigation and promote transparency.

Laws, Regulations, and Policies

• Ensure adherence to Anti-Money Laundering (AML), Counter Financing of Terrorism (CFT), and Data Protection laws.

• Implement compliance programs and foster a culture of ethical behavior.

• Encourage open communication and address potential compliance concerns.

Key Skills and Competencies

• Strong healthcare knowledge, including insurance plans and medical terminology.

• Excellent communication skills for effective interaction with stakeholders.

• Empathy and compassion to support clients in challenging times.

• Problem-solving skills and active listening to address client concerns.

• Effective organizational and time management skills.

• Flexibility and adaptability to changing policies and client needs.

• Commitment to quality improvement in care navigation services.

Qualifications

• Degree/Diploma in clinical studies (nursing qualifications are an added advantage).

• At least 2 years’ experience in a clinical setting.

• Basic understanding of insurance concepts.

Relevant Experience

• Minimum of 3 years’ experience with a strong understanding of medical insurance processes.

How to Apply
Qualified candidates seeking a new challenge are encouraged to apply by visiting the Jubilee Insurance Careers Portal and submitting their application. Ensure you quote the Job Reference Number (JHIL135) and the Position Title by 13th December 2024.

Only shortlisted candidates will be contacted.

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