# Case Management Officer Job Britam, Nairobi, Kenya Canonical URL: https://primejobalerts.com/jobs/case-management-officer-job-britam-nairobi-kenya Company: Britam, Nairobi, Kenya Category: Administration & Office Support Location: Kenya Work type: Full-time Work arrangement: On-site Published: 2026-08-12 Expires: 2026-09-26 ## Job Description ### Job Purpose - Reporting to the Manager Clinicals, the role holder will be responsible for control and managing of the policy cycle through pre-authorization and case management, to ensure quality and cost effective care. ### Key responsibilities - Set the appropriate parameters for each admission (claim reserve, initial authorized cost and duration).  - Interact with clients and service providers to ensure that the care is given within policy guidelines.  - Review medical reports and claims for compliance with set guidelines.  - Liaise with underwriters on scope of cover for the various schemes.  - Ensure that medical scheme members are attended to round the clock with support from 24 hour call centre.  - Poly-Pharmacy – discourage poly-pharmacy by diligent challenging of prescriptions and suggesting better alternatives.  - Generic substitution – Encourage use of generics where indicated as a method of reducing the organizations pharmaceutical expenditure.  - Delegated Authority:  As per the approved Delegated Authority Matrix. - Prepare periodic reports for management on medical claims.  - Ensure claims are processed within the stipulated time.   - Perform any other duties as may be assigned from time to time ### Knowledge, experience and qualifications required - Diploma/Degree in Nursing or Diploma in clinical medicine or Diploma in Pharmacy.  - Understanding of insurance concepts.  - Professional qualification in FLMI, ACII and IIK would be an added advantage. - 3-4 years’ experience in case management ### How to Apply Click here to apply ## Apply Use the canonical Prime Job Alerts page for full application instructions and source verification.