Dennis Meshack Okemwa

OKEMWA DENNIS MESHACK Email :-LinkedIn: https://www.linkedin.com/in/dennis-meshack-okemwa- Address:-, Joska,Nairobi Mobile :- PROFESSIONAL SUMMARY____________________________________________________________ A care management professional with over 6 years of experience across the medical and insurance industries with proven exemplary customer service and people skills. Skilled in case management, Microsoft excel, claims administration, customer service and problem resolution. Led the design of new medical packages for Medical Administrator Kenya Limited which saved over 5 million annually and earned the company best Third-Party Medical Administrator for efficient scheme administration. EDUCATION______________________________________________________________________________________________________ ● Diploma in Clinical Medicine and Surgery [2014] with aggregate of 75% from Medical Training College, Meru High school [2009] with aggregate of 75% from Thika High School Primary school [2005] with aggregate of 85% from Reach The Children Academy ● ● LICENCES______________________________________________________________________________ • Clinical Officers Practising License CERTIFICATES__________________________________________________________________ • • • • • • • • • Certificate Of Completion -Family Planning -JHPIEGO (2014) Diploma in Care Giving – Alison (2022) Certificate Of Completion – Case Management (2022) Certificate Of Completion - Critical Thinking for Better Judgment and Decision-Making (2022) Certificate Of Completion - Customer Service: Handling Abusive Customers (2022) Certificate Of Completion - Introduction to Microsoft Excel(2022) Certificate In Asthma Management (2022) ACLS/BLS – Medtigo Institute(2022) Certificate Of Proficiency - (2023) KEY SKILLS_________________________________________________________________________________________________________ • • • • • Team work Adaptability Self-Confidence Customer service Word/Excel / PowerPoint CORE QUALIFICATIONS________________________________________________________________ • • • • • Exemplary customer service and people skills Leadership abilities that have been proven in small and large-scale arenas Problem solving skills that lead to feasible resolutions for the future Ability to organize large scale projects or departments Great variety of work experience leading to a very well-rounded skill set WORK RECORD____________________________________________________________________________________________________ PELICAN INSURANCE BROKERS(K) LIMITED -(MEDICAL CARE EXECUTIVE) - From 15th of August 2021 to date • • • • • • • • • • Case management including following up admissions,discharges,cost negotiation and disputed medical cases. Handling medical and group life claims. Medical and group life underwriting. Act as the patient's advocate as it relates to insurance coverage and financial assistance. Advocate for clients with advice and information regarding treatment options and clinical status, evaluating medical necessity and appropriating resource utilization. Medical product development - Pelican Afya/Afya Plus medical product in conjuction with Jubilee insurance company. Advising clients on risk management and helping to devise new ways to mitigate risk. Advising clients on whether and when they need to make a claim on their medical policy. Assisting in tender documentation. Developing relationships with underwriters and other related professionals. MEDIHEAL HOSPITAL PARKLANDS (PATIENT CARE MANAGER) JUNE 2021- AUGUST 15TH ,2021 - LOCUM • • • • • • • Assisting the admission team in ensuring admissions are approved under the relevant insurance company / benefit. Facilitating transition of care planning with an interdisciplinary healthcare team to achieve quality outcomes, reduce costs and ensure patient safety. Actively supporting Care Management plans and processes to measure, assess and improve quality, resource management, patient outcomes and Care Management metrics. Assisting to hasten the discharge process under the relevant insurance. Writing medical reports and uploading to relevant insurance companies for approval of hospitalization extension. Filing reports of all admission cases. Assisting the billing and admission team in negotiation of cost for procedures and drugs. MEDICAL ADMINISTRATOR KENYA LIMITED(M.A.K.L.) – (CASE MANAGER & MEDICAL CLAIMS ANALYST) From July 2018 to May 2021 ● ● ● ● ● ● ● ● ● ● Vetting and verification of preauthorization requests - (TSC, NPS/KPS, NCC and Narok county scheme) Negotiation of medical fees and costs with the Service Providers. Managing the daily running of the call center responding to medical questions and inquiries. Assisting in confirmation and justification of rejected cases and making recommendations on appropriate payment of disputed billing as necessary. Confirming treatment given is in adherence to scheme rules and with reasonable pricing. Confirming membership validity and benefits before processing claims and pre-authorizations. Receiving emergency calls, assessing the client’s condition, requesting for an ambulance dispatch for evacuation, informing the receiving facility and following up on the case until the client gets handed over. Identifying fraudulent claims and preauthorizations to reduce costs. Responding to mails, calls and medical related queries. Evaluation of reimbursement claims and making decisions regarding the payment. WORKED AS CLINICAL OFFICER IN BAHATI HOSPITAL JOSKA FROM APRIL 2016 TO JULY 2018 ● ● ● ● ● ● ● Comprehensive history taking, recording and presentation. Performing clinical examination, interpreting findings and managing accordingly. Requesting and interpreting laboratory and radiological investigations. Prescribing and explaining treatment to patients. Managing emergency cases and referring appropriately. Requesting for ambulance in case of referrals, accompanying and monitoring patients, and appropriately handing over to the facility with proper documentation. Filling medical legal documents WORKED AS CLINICAL OFFICER IN REINHA ROSARY MISSION HOSPITAL FROM FEB 2016 TO APR 2016 ● ● ● ● ● ● ● Comprehensive history taking, recording and presentation. Performing clinical examination, interpreting findings and managing accordingly. Requesting and interpreting laboratory and radiological investigations. Prescribing and explaining treatment to patients. Managing emergency cases and referring appropriately. Requesting for ambulance in case of referrals, accompanying and monitoring patients, and appropriately handing over to the facility with proper documentation. Filling medical legal documents REFEREES 1.Caroline Wangui Wanjiku - Medical Claims Manager AETNA -.James Mikwa - Corporate Care Manager - MINET -.Hillary Mahagwa - Supervisor - Pelican Insurance Brokers(K) Ltd -.Dr. Michael Ochoi - Medical Doctor - Mediheal Hospital Parklands -