Joel Ekomu
I am a results-driven and detail-oriented Utilization Review Manager with proven expertise in managing clinical utilization review processes, ensuring appropriate and cost-effective delivery of healthcare services while maintaining compliance with payer requirements and organizational standards. I have a strong background in overseeing the end-to-end utilization management lifecycle, including concurrent reviews, pre-certifications, clinical documentation review, authorizations, appeals, peer reviews, and discharge planning. As a collaborative leader experienced in managing multidisciplinary teams, I possess excellent communication, analytical, and problem-solving abilities, with a strong focus on quality improvement, regulatory compliance, and operational efficiency. I am committed to optimizing utilization review processes, reducing unnecessary healthcare costs, supporting timely patient care, and achieving measurable outcomes that align with organizational goals. I am also highly skilled in building effective relationships with healthcare providers, payers, case managers, and other stakeholders to facilitate timely clinical decisions and ensure continuity of care.
Work History
Utilization Review Manager
1 Year 9 Months- Utilization Review: Conduct reviews of medical records and treatment plans to determine medical necessity and appropriateness of care.
- Case Management: Work with case managers to identify patients who require utilization review and ensure timely and effective care coordination.
- Education and Training: Provide education and training to healthcare providers and staff on Utilization review processes and best practices.
- Care Plan Evaluation: Evaluate care plans and treatment protocols to ensure alignment with established guidelines and standards.
- Compliance: Ensure compliance with regulatory requirements, accreditation standards, and organizational policies related to utilization review and care management.
Credit Officer
1 Year 11 Months- Credit Analysis: Evaluate creditworthiness of clients, analyzing financial statements, credit history, and other relevant data.
- Loan Approval: Make informed decisions on loan approvals, ensuring adherence to credit policies and risk management guidelines.
- Portfolio Management: Monitor and manage credit portfolios, identifying potential risks and implementing mitigation strategies.
- Client Relationship Management: Build and maintain relationships with clients, providing excellent customer service and support.
- Credit Policy Development: Contribute to the development and refinement of credit policies and procedures.
- Risk Assessment: Identify and assess potential credit risks, recommending appropriate actions to minimize exposure.
Data Curator -Access to finance and Health
2 Years 11 Months- Data Management: Collect, organize, and maintain large datasets, ensuring data quality and integrity.
- Data Analysis: Analyze data to identify trends, patterns, and insights, and provide recommendations for improvement.
- Data Governance: Develop and implement data governance policies and procedures to ensure data security and compliance.
- Collaboration: Work with cross-functional teams, including finance, health, and data science, to integrate data insights into decision-making.
- Research Support: Support research initiatives by providing data insights and analysis on access to finance and health.
- Freelancer
Sales and Financial Executive
1 Year 11 Months- Budgeting and Forecasting: Develop and manage budgets and forecasts, ensuring alignment with business objectives.
- Sales Strategy: Develop and execute sales strategies to meet or exceed sales targets.
- Financial Reporting: Prepare financial reports and dashboards to communicate financial performance to stakeholders.
- Financial Planning: Develop financial plans and strategies to support business growth and profitability.
- Negotiation and Closing: Negotiate deals and close sales, ensuring customer satisfaction and meeting sales targets.
Education
BACHELOR OF MICROFINANCE (HONS)
UGANDA ADVANCED CERTIFICATE OF EDUCATION
UGANDA CERTIFICATE OF EDUCATION
PRIMARY LEAVING EXAMINATION
Skills
Certification
- Microsoft office specialist, iCOTECH, 2020-01-01, 2020-01-31, P1M
- Financial planning, budgeting, credit and expenditure management, Global health and HIV AIDS initiative Uganda, 2019-01-01, 2019-01-07, P7D
- Supplier involvement in development of statement of requirements, IPPU, 2020-01-01, 2020-01-14, P14D
- CM - Certified Manager Certification