Care Officer - Microinsurance

About the role

CIC Insurance Group, an insurance and financial services organisation operating in Kenya, Uganda, South Sudan and Malawi, is hiring a Care Officer for its microinsurance business in Nairobi. Reporting to the Assistant Manager Care Management, the role holder ensures the efficient management of insured members' medical care by overseeing approvals, coordinating treatment processes and monitoring benefit use in line with policy guidelines, while delivering high-quality customer support.

Key responsibilities

• Issue medical approvals for inpatient and outpatient services in line with policy terms.
• Monitor inpatient admissions, focusing on treatment costs and average length of stay.
• Provide pre-authorization guidance for scheduled procedures, including optical and dental services.
• Conduct daily hospital visits to support insured members during hospitalization.
• Respond promptly to stakeholder inquiries about medical care management cases.
• Answer medical emergency calls through the 24-hour call center, with a strong focus on customer care.
• Negotiate discounts with doctors and hospitals for specific procedures or high-cost cases and coordinate on SHA/SHIF packages.
• Facilitate medical referrals and emergency evacuations when required.
• Monitor member benefit utilization and share regular updates with stakeholders.
• Prepare and submit reports as directed by management or policy guidelines.
• Review medical reports and laboratory results to assess clinical risk and advise the underwriting team.

Required profile

• Bachelor's degree or diploma in nursing, clinical medicine or a healthcare-related field.
• Minimum of 3 years of experience.

Applications are made through the CIC Insurance Group careers page, stating the position applied for, by close of business on 2 November 2026; only shortlisted candidates will be contacted.