Jubilee Insurance Hiring Manager – Wellness, Nairobi Office

Role Purpose

The Manager Wellness will lead the development, execution, and management of corporate wellness programs. The role holder will focus on driving strategic initiatives that enhance customer and employee well-being, integrating wellness solutions into insurance products, and fostering a culture of preventive healthcare. He/she will also ensure alignment with regulatory requirements and corporate objectives while positioning the company as a leader in health and wellness solutions.

The Wellness Manager will be responsible for implementing and improving Value Based Care, promoting sustainable healthcare delivery through preventive, promotive, and protective strategies. The role also includes overseeing population health initiatives, technology deployment, clinical integration and strategic planning to enhance health outcomes, improve the quality of care, and optimize Total Medical Expense Management.

Main Responsibilities

Strategy

1. Develop, implement and supervise Wellness Programs using evidence-based guidelines to add value, drive clinical performance, improve retention and reduce disparity.
2. Structure, Implement and supervise disease management programs and care coordination through the continuum of care.
3. Structure, Implement and supervise performance of new products and packages that promote preventive health services.
4. Collaborate with members of the Leadership team on the development of the annual Wellness strategic goals and objectives.
5. Spearhead development and successful rollout of preventive health technologies.
   

Operational

1. Serve as one of the organization’s key spokespersons on value-based care, educating clients, employees, clinicians, and other stakeholders on the expected changes in healthcare.
2. Work closely with care management and provider partnerships to foster provider alignment with the clinical strategic priorities of the organization and needs of Jubilee Health clients.
3. Implement and evaluate population health strategies that address the utilization, quality, average cost of care, patient satisfaction, and overall marketplace competitiveness.
4. Work closely with the Head of Clinical Operations to Identify Key Market drivers and develop plans and strategies to address incident rates and claim costs.
5. Work closely with the Head of Clinical Operations to ensure providers adhere to best clinical practices, cost of care standards, and where necessary, address inappropriate or poor performance.
6. Monitor disease-specific and cost of care metrics to ensure the delivery of value-based care within quality standards.
7. Work closely with the Head of Clinical Operations to review, align and implement quality metrics related to patient care.
8. Monitor performance indicators, patient and provider satisfaction and implemented changes to improve customer retention and net promoter scores.
9. Conduct real time analysis of disease trends based on clams’ data and advise the clinical operations team on appropriate interventions.
10. Provide medical expertise and leadership in the development and implementation of clinical disease and population health management strategies.
11. Work closely with the Head of Clinical Operations to develop and implement medical management initiatives and
12. provide leadership in implementation and interpretation of clinical review policies and guidelines, evidence based
13. guidelines, and pharmacy benefits management to achieve set performance standards and targeted
    benchmarks.
14. Implement and supervise prospective, concurrent, and retrospective reviews of medical services provided to covered lives.