Bristol 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.
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 & 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 humanresource@bristolpark.or.ke, clearly indicating the subject line as CARE MANAGER, on or before 19th December, 2025.
Only shortlisted candidates will be contacted.
