Head, Business Development & Managed Care

Job Title: Head, Business Development & Managed Care

Location: Port Harcourt, Rivers
Job type: Full time

About the Role

• To lead the hospital's managed-care function, owning the interface with HMOs and retainership schemes, and ensuring enrollee service, claims and authorization processes deliver both quality care and commercial sustainability.

Responsibilities

• Direct the hospital's managed-care operations and manage relationships with HMO and retainership partners.
• Oversee enrollee verification, pre-authorisation, referrals and management of care within scheme terms.
• Oversee claims preparation, submission, reconciliation and follow-up to minimise rejections and delays.
• Monitor service-level agreements and lead resolution of disputes with scheme partners.
• Coordinate with clinical teams to ensure care is evidence-based, cost-effective and within scheme rules.
• Supervise, coach and develop managed-care, clinical support and customer experience staff.
• Track managed-care performance and revenue, and report findings with improvement recommendations.
• Champion enrollee experience, complaints resolution and retention across the function.

Key Performance Indicators (KPIs)

• Claims rejection rate and average claims turnaround time against target thresholds., Pre-authorisation and referral processing time within agreed service-level windows., Managed-care revenue collected versus billed, and ageing of outstanding claims., SLA compliance and dispute-resolution cycle time with scheme partners., Enrollee satisfaction / complaint-resolution rate and staff performance against team KPIs.

Requirements
Education:

• A relevant First Degree (e.g. health sciences, nursing, public health, business administration, or a related discipline). Completion of NYSC, or a valid exemption where applicable.

Experience:

• Minimum of 8 years of relevant experience in managed care, HMO liaison or healthcare administration, including supervisory experience.

Required skills:

• Strong knowledge of managed-care, HMO and retainership processes.
• Understanding of claims, authorisation and revenue-cycle management.
• Ability to align clinical and commercial requirements.
• Ability to lead, coach and develop a team.
• Strong communication, negotiation and analytical skills.
• Working knowledge of managed-care/claims systems and performance reporting.

Working Relationships:

• {"External":["HMO and retainership scheme partners","Enrollees","Relevant health-insurance bodies"],"Internal":["Chief Medical Officer / management","Clinical departments","Finance and billing","Quality assurance"]}

Application Closing Date
6th October, 2026.

Interested and qualified candidates should:
Click here to apply online