Case Manager, Active Case Management
We currently have an exciting career opportunity for a Case Manager, Active Case Management, within Jubilee Health Insurance Limited. The position holder will report to the Assistant Manager, Active Case Management and will be based at our Head Office in Nairobi.
Key Competencies
I. Clinical knowledge and ability to interpret medical reports and treatment plans
II. Understanding of health insurance policies, benefits, and scheme structures
III. Strong case management and utilization review skills
IV. Analytical thinking and sound decision-making based on clinical and policy guidelines
V. Attention to detail and accuracy in documentation and benefit adjudication
VI. Excellent communication and interpersonal skills for engaging clients, providers, and
internal teams
VII. Customer service orientation with empathy and professionalism
VIII. Negotiation and relationship management skills with service providers and stakeholders
IX. Knowledge of compliance requirements, medical ethics, and healthcare regulations
X. Ability to identify and mitigate fraud, waste, and abuse in claims
Qualifications
I. Bachelor’s degree/Diploma in nursing or clinical medicine, or a related field.
II. Professional Nursing qualification KRCHN licensed by Nursing council of Kenya.
III. Relevant certifications in case management, healthcare management, or clinical specialties.
