Medical Services Officer – Benefit Management

About the role

The University of Malawi’s UNIMED Operations Department seeks a qualified Medical Services Officer to oversee clinical aspects of benefit management and ensure scheme members receive appropriate medical benefits.

Key responsibilities

• Monitor and maintain claim books, update claim and pre‑authorisation forms, and process medical claims in line with clinical guidelines and scheme rules.
• Identify claim issues, facilitate resolutions, and track members exceeding annual limits.
• Provide beneficiaries with accurate advice on treatment options, service providers, benefits, exclusions, and limits.
• Recommend and maintain an updated database of reputable service providers, ensuring their compliance with scheme SOPs.
• Manage confidential beneficiary medical information, produce monthly utilisation reports, and analyse data to improve healthcare delivery.

Required profile

• Bachelor of Science in Clinical Medicine and registration with relevant regulatory authorities.
• Minimum five years’ experience in health insurance, medical scheme operations, or a related clinical setting.
• Self‑starter capable of working independently with strong interpersonal skills.

Required skills

• Proficiency with Health Management Information Systems.
• Advanced Microsoft Word and Excel skills.
• Effective use of email communication tools.