PHB HEALTHCARE LTD: Novemeber 2012 ------ Till date.
POSITION: CUSTOMER CONTACT CENTRE – COORDINATOR / TEAM LEAD
I lead the team that handled the project of setting up a fully functional customer contact centre for my organization.
I was able to draw up a blueprint to suit the interest of all stakeholders. Project was handled in line with approved budget, which further enhanced on time required board approvals. I was also a core member of the recruitment team, when we needed to fill in position for consultants.
I was responsible for coordinating vendors such as Starcomms plc and Synapse global network and worked closely with them to enable us set up a state of the art customer service centre to enhance service delivery and propagate excellent customer service n PHB Healthcare. Training of staff on software(CRM VTIGER) use was also carried out by me following installation and training I received from the software programmer.
Day to day coordination of the contact centre operations
I strategically resolve problems for all customers and known with records to achieve over 97% rates of resolved cases daily.
I take charge of all Tele – marketing activities of company’s products
In charge of approving care requests from Hospitals and customers generally
Coordinates all referrals, within secondary and tertiary institutions
Negotiation of prices for all secondary cases prior approvals, working in line with agreed rates and benefits of the organization
Tariff and premium negotiations with Hospitals and customers respectively
Generating financial proposals for clients as needed, while liaising with the finance unit
Triage management of emergency cases, to enable me coordinate referrals in a more professional manner bearing in mind severity and life threatening situations
Telephonic reviews of cases and physical case management where necessary
Training of clients at their premise on current or prevalent medical conditions, to e as a way of preventive medicine
Coordinates quarterly news letter for PHB Healthcare to all customers
Organizing orientation sessions amongst teams and training of new hires on the unit’s processes
Effective Roaster management to ensure all shifts are covered and efficiently managed
Receiving incoming calls/enquiries and resolving same on time and professionally
PHB HEALTHCARE LTD: May 2010 ------ SEPT.31st, 2012
POSITION: CLIENT SERVICE /PROVIDER COORDINATOR
1. CLIENT SERVICES / ACCOUNT MANAGEMENT & PROVIDER / UTILIZATION NETWORK MANAGEMENT
In this role, I have the responsibility for managing and resolving all complaints from patients and customers. I am responsible for managing all Hospitals on our Network – with the Lagos zone having about one hundred and fifty hospitals and all tertiary institutions in Lagos. I also coordinate member utilization with a number of out station Hospitals in the six geopolitical zones of Nigeria.
In managing these facilities I have a very cordial and sound business relationship with top management staff such as MD’S, PROF. of medicine/ surgery etc and various other heads of department who are key decision makers. I have a mandate to reduce utilization and keep it at the lowest healthiest levels.
CAREER ACHIEVEMENTS – PROVIDER / UTILIZATION MANAGEMENT
I introduced and made applicable the process of Hospital banding, which successfully reduced high claims by over 10% monthly in the last fifteen months.
I take the lead role in tariff negotiations with all providers in the Lagos zone, and have over the years recorded a huge success rate by being able to get discounts of at least 30% - 45%, after every negotiation - thereby saving cost for the company.
I was able to Credential and profile a number of cost effective and very professionally sensitive Hospitals into our Network,
I single handedly included LUTH private wing into our Network, and had to work with top Medical doctors/ consultants to achieve this.
Successfully coordinated/ managed series of complicated interstate referrals and transfers to both private and Teaching Hospitals, where I had to work with a range of professors etc.
I manage all forms of communication materials for the unit, i.e communiqués, business letters to CMD’S, MD’S, Directors, providers and enrollees.
Represents the unit head at all meetings he is unable to attend, and also anchors a greater number of meetings scheduled for the unit.
Actively involved with developing Quality Improvement Policies/ strategies and its administration for Internal and External customers / members
Utilizing effective communication, conflict management and negotiation skills to resolve all client complaints and ensuring satisfaction for each individual case.
CAREER ACHIEVEMENT - CLIENT SERVICES / ACCOUNT MANAGEMENT:
Actively and Passionately involved in developing business and marketing strategies, to help increase the clientele base of the company monthly.
Responsible for managing all corporate / individual accounts in PHB Healthcare, as I ensure all enrollees who access our provider centres MUST get excellent service, satisfaction and value for their premium.
Strategically ensures client retention through excellent customer service management
I introduced value added services to the client service unit to help improve satisfaction by contributing strongly to the company’s news letter, developing tools and training packages for the client service unit.
I serve as a strong resource person for the client service and provider administration unit, where I proffer professional advise and useful/ meaningful contributions to help maintain member satisfaction.
I am accountable for analyzing loss ratios at the end of each policy year and make useful recommendations to the team/ superiors per client/company.
CAREER ACHIEVEMENTS - MEDICAL CASE MANAGEMENT
Official advocate between PHB Healthcare clients and provider centres
Reviews and interpret Medical benefits and exclusions to clients
Functions as a resource to the clinical team/provider centres regarding approved criteria, practices, guidelines and alternative treatment options.
Conducting referrals appropriately to ensure clients’ safety, whilst maintaining a budget
Verification of falsified bills and illogical Medical diagnosis
Responsible for professional Case management and follow - up
Responsible for Collating and writing the unit’s monthly report
CAREER ACHIEVEMENTS - TRAINING
I developed the training packages which are currently been used by PHB Healthcare to train all Hospitals and corporate clients in the Lagos zone – with providers numbering over one hundred and fifty and corporate clientele of over one hundred.
I take the lead role in facilitating trainings and negotiations for all providers in the Lagos zone.
I serve as a Lead facilitator when we need to train / make presentations to our top clients, e.g starcomms, G4S group schlumberger, Wheatherford Nig., Eunisell etc
All induction trainings for starcomms plc - Lagos zone was handled by me and this involved at least twelve branches.
I have the responsibility for creating power point packages for other forms of enlightenment programs/trainings.
EXPATCAREHEALTH: September 2007 ------ May 2010
POSITION: CLIENT ACCOUNT MANAGER (SENIOR SUPERVISOR)
CAREER ACHIEVEMENTS - CLIENT SERVICES / ACCOUNT MANAGEMENT
Managed all Assigned Corporate Accounts
Day to day Complaint Resolutions ( Clients and Hospitals)
Planning, evaluation and Implementation of processes for all Clients
Evaluation of client’s Utilization
Loss ratio Analysis
Emergency / Crisis Management
Providers / Specialist centre Coordination (Giving approvals)
Managing all Secondary Referrals
Assessing claims / reimbursements
Managing all Renewals
Credit control / Monitoring premiums (payments )
Organizing health and wellness programs for clients (Presentations)
Giving Advise on Rates / premium to be approved.
Advising Financial planners / agents on good or bad Businesses and giving approvals as needed.
CAREER ACHIEVEMENTS - CLINICAL NURSING EXPERIENCE (2003, 2005 – 2007)
1. MEDICAL ACCESS LIMITED.
Position - Dialysis Nurse & Application’s specialist; Dec 2006 --- Aug 2007
2. CRITICAL RESCUE INTERNATIONAL LTD.
Position – Head Nurse & Emergency care practitioner; Aug 2005 - Dec 2006
3. ROYAN HOSPITAL OJODU
Position - Nursing and Midwifery officer; May 2005 - 2005 August
4. COUNTY HOSPITAL OGBA, LAGOS:
Position - Nursing officer; Sept 2003 – 2004 Mar