Open to opportunities

Margaret Maina

@margaretmaina3

Message

Healthcare and insurance professional specializing in case management, utilization review, and customer care.

Kenya

Message

What I'm looking for

I seek a customer-facing or business development role leveraging clinical case management, utilization review, and relationship-building to drive service quality and growth.

I am a healthcare and insurance professional with five years' experience across clinical service delivery, insurance case management, call-center operations, and stakeholder coordination.

I have provided timely clinical approvals, managed high-cost cases, coordinated emergency evacuations and negotiated provider discounts to support cost containment and continuity of care.

I translate complex medical information into practical guidance for customers and non-clinical stakeholders, improving satisfaction and supporting retention through clear communication and responsive service.

I am prepared to leverage my clinical expertise, customer service skills, and data-informed problem solving in business development or customer-facing roles that prioritize relationship building and operational performance.

Experience

Work history, roles, and key accomplishments

Current

Care Manager

Current

Jubilee Health Insurance

Jul 2024 - Present (1 year 6 months)

Provide clinical approvals and manage high-cost and chronic cases, negotiating provider discounts and coordinating emergency transfers to reduce claims expenditure and improve continuity of care.

Case Management Utilization Review Care Coordination Medical Documentation Reporting Tools

Nurse Call Centre Executive

CIC Group Limited

Aug 2023 - Jul 2024 (11 months)

Provided 24-hour clinical triage and preauthorizations, managed admission parameters and tracked inpatient utilization to control claims exposure and support policyholder advocacy.

Triage Utilization Management Patient Advocacy Admissions Data Analysis Customer Support

Clinical Officer

Ruai Family Hospital

Mar 2023 - Aug 2023 (5 months)

Delivered inpatient and outpatient care, managed emergencies, interpreted diagnostics, and maintained compliant patient records to ensure safe clinical outcomes and continuity of care.

Clinical Assessment Emergency Care Medical Documentation Patient Education Care Coordination

Clinical Officer

Express Family Hospital

Jan 2022 - Jul 2022 (6 months)

Provided comprehensive outpatient management and emergency care, ordered and interpreted investigations, and supported continuous medical education to maintain clinical best practices.

Emergency management Diagnostic Testing Health Education Team Collaboration Continuing Education

Clinical Officer

Equity Afia

Nov 2021 - Jan 2022 (2 months)

Delivered clinical services within a primary care network, supporting patient assessment and treatment across routine presentations and contributing to facility workflows.

Primary Care Clinical Assessment Patient Management Medical Documentation Teamwork