Job Reference Number JHIL100016 Qualifications: Bachelor's degree/Diploma in nursing or clinical medicine, or a related field. Professional Nursing qualification KRCHN licensed by Nursing council of Kenya. Relevant certifications in case management, healthcare management, or clinical specialtie Clinical knowledge and ability to interpret medical reports and treatment plans Ability to identify and mitigate fraud, waste, and abuse in claims Minimum of two (2) years of relevant experience in a similar or equivalent role within a medical insurance environment, with demonstrated expertise in inpatient care coordination, insurance benefit administration, policy interpretation, and pre-authorization processes. Experience in provider engagement will be an added advantage. go to method of application »