Job Description
Job Ref. No: JHIL092
Position: Assistant Manager, Care Navigation
Jubilee Insurance was established in August 1937, as the first locally incorporated Insurance Company
based in Mombasa. Jubilee Insurance has spread its sphere of influence throughout the region to become
the largest Composite insurer in East Africa, handling Life, Pensions, General and Medical Insurance.
Today, Jubilee is the number one insurer in East Africa with over 450,000 clients. Jubilee Insurance has a
network of offices in Kenya, Uganda, Tanzania, Burundi, and Mauritius. It is the only ISO certified
insurance group listed on the three East Africa stock exchanges – The Nairobi Securities Exchange (NSE),
Dar es Salaam Stock Exchange and Uganda Securities Exchange. Its regional offices are highly rated on
leadership, quality and risk management and have been awarded an AA- in Kenya and Uganda, and an A+
in Tanzania. For more information, visit www.JubileeInsurance.com.
We currently have an exciting career opportunity for an Assistant Manager, Care Navigation within
Jubilee Health Insurance Limited. The position holder will report to the Manager Wellness and will
be based at our Head Office in Nairobi.
Role Purpose
As the Assistant Manager, Care Navigation, you would be responsible for handling all inpatient and
specialized test preauthorization, and communicating with providers, clients, and brokers on a timely basis for
any undertakings, rejections, or relevant concerns.
Main Responsibilities
Strategy
1. Improve business retention by actively engaging the company’s clients in care navigation.
2. Ensure full utilization of Jubilee Health Insurance’s navigation and wellness programs.
Operational
1. Ensure navigation Programs using evidence-based guidelines add value, drive clinical performance,
improve retention, and reduce disparity.
2. Implement disease management programs and care coordination through the continuum of care.
3. Ensure optimal update of case management concurrent review notes.
4. Ensure implementation of population health strategies that address the utilization, quality, average cost
of care, patient satisfaction, and overall marketplace competitiveness.
5. Regularly develop a database of statistics and narratives for tracking progress and efficacy of treatments
and activities for care navigation outcomes and incidence rates.
6. Ensure high enrollment of members to the Jubilee Mum’s Wellness Club, Chronic disease management
program and loyalty program.
7. Designing and implementing navigation care plans and programs by offering support and tracking
progress.
8. Support call center staff by coordinating navigation, training, and escalation processes regarding the
Company Navigation programs.
9. Participate in member education and training to clients on the various navigation programs in the
business.
10. Ensure care navigation functions realize quality improvement in medical management, improve quality
and access to care, reduce claims costs and demonstrate evidence based clinical outcomes.
11. Ensure navigation protocols that require collaboration with providers transition seamlessly across the
continuum.
12. Ensure health navigators communicate and collaborate with providers to establish clinical programs
improve the quality and efficiency of care while providing value to all stakeholders.
13. Providing technical and Operational support to all internal and external stakeholders i.e., Case
Management, Provider Partnerships, Claims Department, Business Development, Clinical Operations,
regional office, third party administrators, brokers on provider relation matters
Corporate Governance
1. Ensure compliance to any regulatory or health sector changes e.g., changes in billing/payments
requirements, changes in the health legislation affecting the business.
2. Ensure compliance to any regulatory or health sector changes including data privacy and keep abreast of
changes in the health legislation affecting the business.
Leadership & Culture
1. Provide coaching, guidance, and mentorship to staff, promoting professional development and
knowledge sharing within the team.
Key Competencies
1. Manage an up-to-date comprehensive provider panel
2. Provider onboarding and contracting
Qualifications
1. Bachelor’s Science degree in Nursing/Clinical Medicine & Surgery
2. Basic understanding of the concepts of insurance
3. Proficient in the use of Microsoft office suite and packages.
Relevant Experience
Minimum of 5 years of relevant working experience in a similar or equivalent with at least two years in
Clinical Practice. Experience in Claims Processing is an added advantage .