Liberty Life Analyst, Care Management Jobs in Kenya



Liberty Life Analyst, Care Management Jobs in Kenya; The role holder will be responsible for ensuring that Heritage customers receive affordable, accessible, cost‑effective, and high‑quality healthcare services.

Key Responsibilities

  • Maintain constant contact with hospitals to ensure continuous well‑being of stakeholders and efficient handling of medical claims.

  • Pre‑authorise scheduled and non‑scheduled admissions within set guidelines.

  • Liaise with hospitals and doctors for prompt discharge planning of admitted members.

  • Assess and authenticate inpatient and outpatient medical claim documents.

  • Ensure smooth discharge process and coordinate necessary post‑hospitalisation care.

  • Pre‑screen and vet inpatient, outpatient, and reimbursement claims to ensure adherence to tariffs and clinical protocols, with documented notes for declines and discounts.

  • Conduct hospital visits and monitor inpatient bills.

  • Monitor interim bills daily and implement interventions for high‑quality care.

  • Provide daily status reports on admitted members’ clinical condition.

  • Manage contact centre operations, pre‑authorization approvals, and respond to member and provider enquiries.

  • Notify stakeholders of declined cases as per policy guidelines.

  • Resolve client complaints promptly.

  • Respond to all client and provider requests within 24 hours.

  • Ensure counter‑guaranteed and roaming cases have official letters before approvals.

  • Authorize maternity bookings and issue wellness letters within 24 hours.

  • Monitor clients with chronic diseases by ensuring managed healthcare forms are completed
    for proper follow‑up.

  • Organize health talks, wellness programmes, and check‑ups with providers and stakeholders.

  • Ensure inculcation of the Treating Customers Fairly (TCF) culture.

  • Embrace governance requirements regarding KYC, AML, and data protection.

    Qualifications
  • Degree or Diploma in Medicine, Nursing, Clinical Officer, or Pharmacy.

    Experience
  • Minimum of 1 year’s technical knowledge in medical insurance or hospital setting.

    Competencies
  • Understanding of health insurance operations and concepts.

  • Knowledge of medical claims processes and procedures.

  • Stakeholder management.

  • Customer service.

    How to apply

    For more information and job application details, see; Liberty Life Analyst, Care Management Jobs in Kenya

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