New
1 week ago
Job Summary
We are looking for a detail-oriented HMO Officer to manage and coordinate health maintenance organization (HMO) activities within the organization. The ideal candidate will serve as a liaison between the company, employees, and HMOs to ensure smooth healthcare service delivery, effective claims management, and compliance with healthcare agreements.
- Minimum Qualification : Degree
- Experience Level : Entry level
- Experience Length : 2 years
Job Description/Requirements
Responsibilities
- Coordinate the enrollment of employees in HMO plans, including registrations, renewals, and cancellations.
- Manage relationships with HMOs, hospitals, and other healthcare providers.
- Resolve issues related to healthcare service delivery, including claims and coverage concerns.
- Monitor and ensure compliance with HMO contracts and agreements.
- Handle medical claims processing, including reviewing, filing, and tracking claims to ensure timely reimbursements.
- Respond to employee inquiries regarding HMO benefits, plan options, and processes.
- Maintain and update records of employee healthcare plans and utilization.
- Generate periodic reports on HMO activities, costs, and employee utilization trends.
- Assist in negotiating HMO terms, premiums, and benefits with providers.
- Ensure adherence to relevant laws and regulations governing HMOs and healthcare administration.
Requirements
- BSc/HND in Business Administration, Health Management, or a related field.
- 2 years of experience in HMO operations, healthcare administration, or a similar role.
- Strong knowledge of healthcare management, HMO processes, and claims resolution.
- Excellent communication and negotiation skills.
- Strong organizational skills with attention to detail.
- Proficient in Microsoft Office Suite and other relevant software.
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