Health Risk Manager – Mozambique

About the role

The Health Risk Manager will lead a cost‑effective Managed Health Care programme in Mozambique, ensuring appropriate use of private healthcare facilities while controlling costs and delivering quality patient outcomes. This role supports the Momentum Group’s portfolio of wellness and insurance brands.

Key responsibilities

• Coordinate post‑hospital care in line with business practices and product rules.
• Educate members on health benefits to improve understanding and satisfaction.
• Develop, implement and communicate clinical guidelines for cost‑effective care.
• Authorize medical care that aligns with product and business procedures.
• Implement programs to reduce high‑cost hospitalisations linked to chronic diseases.
• Monitor chronic disease management programmes and ensure correct application of exclusions.
• Handle escalated queries, resolve incidents promptly and maintain accurate documentation.
• Identify financial and business risks and communicate with providers to improve cost efficiency.

Required profile

• Medical Doctor qualification with professional registration.
• 3–5 years of clinical and case‑management experience.
• Knowledge of managed healthcare systems.
• Strong communication, analytical and problem‑solving abilities.
• Compassionate, organised and client‑focused approach.

Required skills