Job Openings at MetroHealth HMO Limited – Apply Now

MetroHealth HMO Ltd is seeking a highly experienced and competent Medical Manager to join our team.

Job Summary

The Medical Manager will oversee clinical operations, provider network management, claims adjudication oversight, case management, and ensure quality healthcare service delivery in line with regulatory and organizational standards.

Requirements

• Must be a qualified Medical Doctor (MBBS/MBChB) with a valid practicing license
• Minimum of 5 years’ relevant experience in the Health Maintenance Organization (HMO) space
• Strong knowledge of healthcare management, utilization review, and provider relationship management
• Sound understanding of NHIA regulations and healthcare quality standards
• Strong analytical, leadership, and decision-making skills
• Excellent communication and stakeholder management abilities
• Proficiency in healthcare data analysis and reporting

Key Responsibilities

• Oversee medical operations and clinical service delivery
• Manage provider network performance and relationships
• Review and authorize medical claims where necessary
• Ensure compliance with regulatory and internal clinical standards
• Drive quality assurance initiatives and cost-effective healthcare delivery
• Provide medical advisory support to management

Only candidates with proven HMO experience and who are qualified Medical Doctors will be considered

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MetroHealth HMO Ltd is seeking a qualified and dedicated Call Centre Executive (Registered Nurse) to join our team.

Job Requirements

• Must be a Registered Nurse (RN) with valid professional certification
• Bachelor’s Degree or Diploma in Nursing
• Relevant experience in healthcare service delivery or HMO operations is an added advantage
• Strong communication and customer service skills
• Ability to handle patient/provider inquiries professionally
• Good knowledge of healthcare processes and medical terminology
• Strong problem-solving and multitasking abilities
• Proficiency in computer applications

Key Responsibilities

• Attend to enrollees’ inquiries and complaints professionally
• Provide accurate information on healthcare benefits and authorization processes
• Liaise with healthcare providers and members to resolve issues promptly
• Escalate medical and operational concerns where necessary
• Maintain accurate records of calls and service requests
• Deliver excellent customer support in line with company standards

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