Care Manager
- Kisumu Hospital
- Permanent
- 23, Jul 2025
- Other
Purpose Statement
Our purpose is to enable and maintain health.
Mission
To provide high quality care that exceeds our clients’ expectations.
Job Description
About Avenue Healthcare
Avenue Healthcare is one of the leading private healthcare groups in East Africa running 3 Hospitals, and 16 Medical Centres across Kenya, and a Homecare business. With over 25 years in the healthcare industry, Avenue Healthcare runs 300 hospital beds with over 1,000 staff members, and more than 400 specialists and serves over 400,000 patients annually, offering primary, secondary, and tertiary healthcare services.
Job Objective/Purpose
To Monitor ongoing quality, productivity, efficiency and cost effectiveness of services and liaison person with third party payers.
Key Responsibilities
1.Conducts daily in patient rounds of the specific scheme beneficiaries admitted in the hospital. To ensure timely and appropriate admission, diagnosis, and treatment, care of patients and advise the hospital and the corporate accordingly.
2.Ensure only authentic pre-authorizations are issued for clients seeking medical services in collaboration with the clinical medical team.
3.Draw monthly reports for specific corporate clients inclusive of trends, analysis, market intelligence for improved business development
4.Liaise daily with other concerned units especially credit control and clinical department to seek amicable solutions to problems related to our billing and invoicing system.
5.Conduct a regular review of the case process to identify gaps to enhance profitability as well as efficiency and effectiveness in the case management process.
6.Enhance customer experience – establish and maintain good relationships with external and internal stakeholders such as underwriter’s, brokers, agents, and policy holders.
7.Source, analyze and provide relevant information to the management for further decision making.
8.Support development of a preventative care program through health talks, wellness, that is a key value proposition to the hospital business chronic disease management program.
9.Prepare the business reports on a daily or weekly basis as and when need be.
10.Ensure incidents are documented by respective staff and discussed with the head of department at all times.
11.Attend inter-phasing departmental meetings and convene meetings every fortnight to identify gaps in care co-ordination in-order to improve services.
12.Collaborate and co-ordinate with other departments, Consultants and other Clinicians to improve overall health service delivery in the department.
13.Conduct continuous impact assessments and identified the most appropriate strategies to bridge established gaps in order to enhance efficiency in service delivery.
14.Induction of new staff working in inter phasing departments as per the departmental/unit procedure manuals.
15.Continuously improve on the hospital business NPS
16.Any other duty as assigned by the supervisor in line with the job description.
Person Specification
•Kenya Registered Community Health Nurse or Kenya Registered
•Nurse / Midwife with 3 years’ experience and above or other relevant qualification
•Certificate in computer application skills from a recognized institution.
•Valid Kenyan nursing practice license.
•Up to date BLS certificate
•3 years proven experience as a care manager
•In-depth knowledge of health and safety guidelines and procedures
•Extensive knowledge of insurance policies
•Knowledge of legal regulations and best practices in healthcare
•Excellent knowledge of emergency care
Only shortlisted candidates will be contacted. Avenue Healthcare is an Equal Opportunity Employer.
