CARE MANAGER

Position titleCARE MANAGERDescriptionBristol Park Hospital is a licensed healthcare provider that has been in operation for over 17 years, **offering quality and affordable healthcare services** in Nairobi, Kajiado, and Machakos counties. Guided by our “To be a world-class provider of quality, innovative, and accessible healthcare solutions,” we are committed to excellence in service delivery as well as patient care and safety. We are seeking to recruit a highly skilled, experienced, and dynamic professional to join our team as Care Manager.Responsibilities**Key Responsibilities****.** Coordinate all inpatient and outpatient pre-authorization requests, extensions, and undertakings with payers. **.** Ensure timely submission, follow-up, and approval of pre-authorizations and extensions within required turnaround times. **.** Liaise with insurers, brokers, patients, and internal clinical teams to provide timely communication and clarification. **.** Validate and manage undertakings, guarantee of payments, and financial exposures for admissions and specialized procedures. **.** Ensure accuracy, completeness, and compliance of documentation and medical reports required by payers. **.** Review service validity, membership, and benefit coverage against payer rules and clinical standards. **.** Maintain accurate and structured records of authorization activities, including high-value cases. **.** Coordinate inward and outward referrals, ensuring complete documentation and seamless continuity of care. **.** Monitor trends, generate reports (daily, weekly, monthly), and identify gaps for continuous improvement. **.** Support interdepartmental communication to enhance timely service flow and customer experience. **.** Conduct capacity building for staff on appropriate billing and care coordination. **.** Uphold compliance with regulatory, ethical, and care quality standards.Qualifications**Qualifications & Experience****Essential** **.** Bachelor’s Degree in Nursing, Clinical Medicine, or related healthcare field. **.** Minimum 3 years’ experience in: **.** Care coordination / Case management **.** Utilization review **.** Medical insurance liaison **.** Claims processing **.** Admission and discharge management **.** Experience working with insurers, payers, and TPAs. **.** Proven ability to interpret medical documentation, reports, and treatment plans. **Desirable** **.** Certification in Case Management, Utilization Management, or Health Insurance. **.** Experience in referral coordination or clinical pathways. **.** Experience in a multi-specialty hospital environment. **.** Experience using HIS/EMR authorization modules.**How to Apply** Interested and qualified candidates are invited to send their application letter, detailed CV, and academic certificates to [email protected], clearly indicating the subject line as **CARE MANAGER,** on or before 19th December, 2025.

Only shortlisted candidates will be contacted.Job Location #J-18808-Ljbffr