Optometry Officer

CIC Insurance Group

The CIC group has for more than three decades shouldered the risks of Kenyans by providing flexible Insurance and financial services built around their needs. With time, we have innovatively created customized products that have cemented our position as a trusted insurance and financial services provider. Our positioning is simplified and captured in our tagline “We Keep Our Word” reinforcing our commitment to the market.

In 2012 the group won The Annual Insurance Claims Settlement Award for consistently paying our claims on time and was also recently listed at the Nairobi Securities Exchange (NSE). With a compounded annual growth rate of 62% in the past 5 years, our unique M-Bima product has seen us emerge as leading providers of micro-insurance in Kenya.

With a total of 3,878 shareholders and a capital base of Ksh 2.1 billion and 1.3 Million clients, the group ranks among the most successful and fastest insurance company in Kenya and the leading co-operative insurer in Africa. We are also targeting to expand operations in the East and Central parts of Africa.
 

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https://cic.co.ke/

Optometry Officer

About the Role

Reporting to the Assistant Manager – Call Centre and Outpatient Services, the role holder will be responsible for timely adjudication of optical claims, in accordance with CIC medical policy provisions, monitoring claim trends, optical cost management, and maintaining expected service level agreements already in place with our clients and stake holders. The role will ensure best clinical practices are adhered to in relation to prescription and dispensation of spectacles, while providing timely and valuable insights for value-based care.

Key Responsibilities

  •  Accurate adjudication of all Optical claims in accordance to Scheme’s policy provisions.
  • Maintenance of high servicing levels by issuing approvals within 15minutes and sharing daily optical TAT report
  • In-depth analysis of claim trends and maintenance of accurate revisit registers
  • Respond to Optical related calls and email complaints within 24hours of notification and timely escalation as per escalation matrix
  • Facilitate issuance of letters of undertaking for scheduled ophthalmological procedures and cases requiring day case and inpatient ophthalmology care
  • Institutionalize robust optical and ophthalmological cost management initiatives through discount negotiation, fraud detection and investigation, costing, and optimization of SHA ophthalmological packages.
  • Conduct cost versus clinical validation of optical prescriptions, lens and frames choices, diagnoses requirements to prevent inappropriate costing, or incongruent prescriptions.
  • Conduct regular Optical provider forensic mystery shopping and physical audits of at least 5 providers quarterly and share audit report with management.
  • Negotiate at least 5 preferred Opticians per quarter and help drive traffic to the preferred panel
  • Any other duty as may be assigned by the supervisor.

Who We’re Looking For

Essential Knowledge/Skills and Experience Required:

  • Diploma in Optometry and Vision Sciences
  • Licensed by KHPOAP
  • Minimum of 3 (three) years relevant experience in a busy medical environment  
  • Experience in an insurance firm is an added advantage
  • Customer experience training will be an added advantage

Key Competencies:

  • High attention to detail and accuracy
  • Analytical & problem – solving
  • Good communication and stakeholder management skills.

Method of application

If you are interested and qualified, kindly submit your application via the link provided below,

https://careers.cicinsurancegroup.com/job/optometry-officer/?utm_source=Jobinkenya

Deadline April 15, 2026

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