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Reliance Health uses Technology to Make Healthcare Accessible and Affordable. Through an integrated approach that includes affordable health insurance, telemedicine, and a combination of partner and proprietary healthcare facilities, Reliance Health offers innovative healthcare solutions that meet the needs of emerging markets.

We are recruiting to fill the position below:

Job Title: Case Manager (Freelance)

Location: Kano

The Role

  • The Case Manager will be responsible for conducting clinical case reviews at designated healthcare facilities, with a focus on identifying fraud, waste, and abuse, as well as performing morbidity and mortality audits.
  • The role ensures that care delivery aligns with clinical standards, ethical guidelines, and cost-efficiency expectations.
  • The Case Manager provides independent, evidence-based clinical insights to support decision-making without commercial bias.

 

What You’ll Do

  • Conduct on-site clinical reviews at assigned healthcare facilities.
  • Review patient cases to assess clinical appropriateness, quality of care, and adherence to established standards.
  • Perform morbidity and mortality audits to evaluate patient outcomes and identify opportunities for improvement.
  • Provide structured, evidence-based recommendations following clinical reviews and audits.
  • Identify patterns of unnecessary, excessive, inappropriate, or potentially fraudulent healthcare services.
  • Investigate suspected cases of fraud, waste, and abuse at healthcare facility level and document findings accordingly.
  • Escalate critical issues and high-risk findings to the appropriate internal stakeholders.
  • Provide independent clinical opinions and recommendations based on reviewed cases and available evidence.
  • Prepare detailed reports and documentation following facility visits and case reviews.
  • Support internal teams with insights and recommendations on complex clinical cases and healthcare delivery concerns.
  • Engage professionally with healthcare providers and facility representatives during reviews and investigations.
  • Maintain professional independence, objectivity, and confidentiality while carrying out assigned duties.
  • Collaborate with internal clinical, operations, and quality teams to support organizational goals and healthcare outcomes.
  • Ensure compliance with applicable clinical guidelines, medical ethics, regulatory requirements, and organizational policies.
  • Stay informed on current clinical standards, healthcare regulations, and industry best practices relevant to case management activities.

Requirements
What You’ll Bring:

  • Bachelor of Medicine, Bachelor of Surgery (MBBS or equivalent) or Bachelor of Nursing (BNS)
  • Valid, unrestricted medical or nursing license to practice in Nigeria
  • Minimum of 3 years of clinical practice experience
  • Strong understanding of clinical guidelines and standards of care
  • Experience in clinical audits, case review, or hospital practice
  • High level of integrity and adherence to medical ethics
  • Strong analytical and reporting skills
  • Ability to work independently in field-based environments

Compliance Requirements:

  • No history of felony or misconduct related to patient care, controlled substances, or professional trust
  • Must disclose any ongoing or pending investigations affecting licensure or practice

Nice to Have:

  • Experience in health insurance, claims review, or utilization management
  • Prior exposure to fraud, waste, and abuse investigations.

Benefits

  • ₦50,000 per resolved case (Fraud, Waste & Abuse investigations)
  • ₦50,000 per resolved case (Morbidity & Mortality audits).

Application Deadline: Unspecified 

Method of Application

 
Interested and qualified candidates should use link below to Apply.

Click here to apply online

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