Position: Quality assurance officer - 18 POST
Education: Degree
Mode of application: Application system
Deadline: 2018-03-19
DUTIES AND RESPONSIBILITIES:
i. Receiving and verifying all claim forms;
ii. Processing, verification and checking of claims and prescriptions in ensuring adherence to stipulated standards;
iii. Attending and addressing members enquiries and complaints;
iv. Visiting and scrutinize all admitted patients in the facility;
v. Collecting and approving patient over stay for admitted clients in respective facility;
vi. Informing on any misconduct noted at respective facilities or any salient findings;
vii. Advise the Fund on various issues related to improvement in claim processing, quality improvement and curbing fraud;
viii. Preparing and submitting periodic work reports to the supervisor;
ix. Performing necessary quality assurance activities at the facility; and
x. Performing any other related duties as may be assigned by the supervisor.
QUALIFICATION AND EXPERIENCE:
- Degree in clinical Medicine from a recognized University or Institution,
- Licensed Medical Practitioner Certificate from Medical Council of Tanganyika or Medical Council of Zanzibar.
- Experience in working in tertiary hospital levels (Regional, Zonal and National) and other analyzed criteria in performing Quality assurance duties (claims management, health advocacy and information management).
- At least two years working experience in clinical medicine and should be computer literate (MS Word and excel) and capable of utilizing approved Fund’s electronic systems in claims management, approval of services and membership management
REMUNERATION: Salary Scale NHIF SCALE
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