Duties
– Coordinate clinical activities and direct engagement with healthcare providers on any funding requests and respond to members in the office when required
– Ensure effective feedback and coordination of care and grant appropriate approvals and authorizations with the support of the medical advisory office
– Make themselves available for involvement during emergency evacuations to gather critical information for efficient and rapid decision making and coordination of medical evacuation processes between front and fund offices
– Share routine case management information on site, provided timely for medical case analysis and appropriate authorizations for evacuations
– Resolve escalated Provider queries with support from Maputo Provider Management Team and escalate queries as appropriate for rapid resolution
– Conduct provider clinical utilization reviews with the support of the Care Team
– Support Provider Fee Management Negotiation process – clinical verification
– Engage with the company’s Clients in country when required