Responsibilities:

State Operations Management:

Coordinate daily HMO operations across Nasarawa State.
Implement management directives and ensure compliance with operational procedures.
Monitor state activities and submit periodic performance reports to management.

Provider Relationship Management:

Maintain effective relationships with accredited healthcare providers.
Monitor provider service quality, accessibility, and compliance with HMO requirements.
Identify and escalate provider complaints, service gaps, and operational challenges.

Enrollee Management and Customer Service:

Coordinate enrollee registration, data verification, and maintenance of enrollee records.
Address enrollee complaints and ensure timely resolution of service-related issues.
Support sensitisation and awareness activities for enrollees and corporate clients.

Claims Coordination:

Facilitate the submission and review of claims documentation by healthcare providers.
Follow up on outstanding claims issues in collaboration with the Claims Unit.
Identify irregularities and escalate suspected fraud, abuse, or unauthorised healthcare utilisation.

Client Relationship Management:

Maintain relationships with corporate clients, government agencies, and other stakeholders.
Monitor client satisfaction and promptly address service concerns.
Support client retention and renewal activities.

Business Development Support:

Identify prospective corporate clients, government institutions, and other business opportunities.
Support marketing, enrolment drives, and health insurance sensitisation campaigns.
Provide market intelligence and business development leads to the appropriate department.

Compliance and Reporting:

Ensure state operations comply with company policies, contractual obligations, and applicable regulatory requirements.
Maintain accurate operational records and protect confidential enrollee and company information.
Prepare and submit regular reports on enrolment, provider performance, complaints, claims issues, and business development activities.

Stakeholder Engagement:

Represent the HMO professionally in approved state-level meetings and engagements.
Maintain productive relationships with relevant government officials, healthcare providers, and other stakeholders.
Escalate significant operational, regulatory, and reputational risks to management.

Requirements:

HND in Business Administration, Health Administration, Public Administration, Social Sciences, or a related discipline.
A qualification in Health Insurance, Health Management, or a related field will be an added advantage
Minimum of 2 years' relevant experience in HMO operations, health insurance, healthcare administration, customer relationship management, or a related field.
Experience managing healthcare providers, corporate clients, or government stakeholders is an advantage.
Familiarity with health insurance enrolment, claims processes, and provider management is desirable.
Knowledge of HMO operations and healthcare delivery systems
Strong communication, negotiation, and relationship management skills.
Good reporting, documentation, and record-keeping abilities.
Proficiency in Microsoft Office and electronic data management systems.
Problem-solving, organisational, and coordination skills.
Ability to work independently, meet deadlines, and manage competing priorities.
High integrity, confidentiality, accountability, and professionalism.

Personal Attributes:

Key Performance Indicators (KPIs):

State Coordinator

Ashmed Integrated Health Services Limited