HMO MEDICAL OFFICER AT KIYIX RECRUITMENT HUB | HMO MEDICAL OFFCICER JOBS IN RIVERS

About Company:

 KIYIX is a recruitment/HR consulting firm and our goal is to to help create one million jobs in Nigeria by 2030. At  Kiyix recruitment hub, we help make recruitment a stress-free experience for both the employer and the potential job seekers.

Job Description:

We are seeking a clinically sound and administratively adept Medical Officer to join our healthcare team in Rumudara, Port Harcourt. This is a strategic role that bridges the gap between clinical excellence and Health Maintenance Organization (HMO) efficiency.

In this position, you will be the gatekeeper of healthcare standards—providing direct medical consultations while overseeing the utilization management process. Your role is critical in ensuring that our members receive evidence-based care while maintaining the fiscal and regulatory integrity of the HMO operations. If you are a licensed physician with a keen interest in healthcare management and at least 2 years of experience, we invite you to lead our clinical operations.

Requirements:

1. Clinical Care & Consultation

• Direct Patient Care: Provide high-quality medical consultations, diagnoses, and treatments to members in accordance with clinical guidelines.

• Evidence-Based Practice: Ensure that all medical interventions are necessary, safe, and cost-effective.

• Health Program Development: Design and implement preventive health programs and wellness services tailored to the member population.

2. Utilization Management & Claims Review

• Claims Governance: Review and adjudicate medical claims to ensure they are clinically justified and align with approved tariffs.

• Authorization Oversight: Manage pre-authorization requests for secondary and tertiary care, ensuring a seamless experience for the patient while controlling costs.

• Provider Collaboration: Act as the primary liaison between the HMO and a network of healthcare providers to resolve clinical disputes and optimize service delivery.

3. Compliance & Quality Assurance

• Regulatory Stewardship: Ensure all medical activities comply with MDCN regulations, NHIA (HMO) guidelines, and national healthcare standards.

• Medical Audit: Perform periodic audits of healthcare provider facilities to ensure they meet the quality and safety standards required by the organization.

• Reporting: Prepare detailed clinical and operational reports for management, highlighting trends in disease burden and healthcare utilization.

Qualifications and Skills:

Professional Profile

• Education: MBBS degree from a recognized university.

• Licensure: Valid and current medical registration with the Medical and Dental Council of Nigeria (MDCN).

• Experience: Minimum of 2 years of post-NYSC experience in a clinical or healthcare setting.

• Advantage: Prior experience in HMO operations, medical insurance, or utilization review is a significant plus.

Core Competencies

• Communication IQ: Exceptional interpersonal skills to navigate conversations with patients, hospital administrators, and insurance stakeholders.

• Analytical Thinking: Ability to interpret complex medical records and identify patterns in claims data.

• Ethics: High level of professional integrity, particularly regarding patient confidentiality and cost-containment ethics.

Salary

Application Closing Date: Not specified

Application Instructions:

Interested and qualified candidates should send their CV to: kicvacancy@gmail.com using the Job Position as the subject of the mail.

Note: For more enquiries, WhatsAppto 07035183843.