Joel Ekomu
Summary
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.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Utilization Review Manager
Revelooprcm
01.2025 - Current
- 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
Goldsmith Credit and Finance Limited
01.2023 - 12.2024
- 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
Veeva Systems
01.2021 - 12.2023
- 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
Sanlam Life Insurance Limited
01.2020 - 12.2021
- 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) - undefined
KYAMBOGO UNIVERSITY
01.2024
UGANDA ADVANCED CERTIFICATE OF EDUCATION - undefined
RESTORE LEADERSHIP HIGH SCHOOL
01.2014
UGANDA CERTIFICATE OF EDUCATION - undefined
NGORA HIGH SCHOOL
01.2012
PRIMARY LEAVING EXAMINATION - undefined
OLIO PRIMARY SCHOOL
01.2008
Skills
- Excellent Negotiations skills
- Guiding teams/Programs in preparation of financial Plans
- Asset management
- Ability to plan and prioritize tasks
- Financial risk management
- Ability to Quickly understand and adopt to different processes and policies
- High level of integrity
- Honesty and accountability
- Finance and credit analysis
- Office/administrative management
- Financial management training for staff
- Financial policy development and review
- Financial planning
- Credit management
- Effective communication
- Financial ERP management
- Vendor Sourcing
- Financial process flow management
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
Languages
English
Ateso
Timeline
Utilization Review Manager
Revelooprcm
01.2025 - Current
Credit Officer
Goldsmith Credit and Finance Limited
01.2023 - 12.2024
Data Curator -Access to finance and Health
Veeva Systems
01.2021 - 12.2023
Sales and Financial Executive
Sanlam Life Insurance Limited
01.2020 - 12.2021
BACHELOR OF MICROFINANCE (HONS) - undefined
KYAMBOGO UNIVERSITY
UGANDA ADVANCED CERTIFICATE OF EDUCATION - undefined
RESTORE LEADERSHIP HIGH SCHOOL
UGANDA CERTIFICATE OF EDUCATION - undefined
NGORA HIGH SCHOOL
PRIMARY LEAVING EXAMINATION - undefined
OLIO PRIMARY SCHOOL