About Us CIC Insurance Group is a leading insurance and financial services organisation with more than five decades of experience helping individuals, families, and organizations achieve financial security. We have grown into a dynamic Group offering life, general, micro insurance, asset management, and investment solutions, with operations in Kenya, Uganda, South Sudan, and Malawi, and are listed on the Nairobi Securities Exchange. Our tagline, “We Keep Our Word,” reflects our unwavering commitment to integrity, transparency, and delivering on our promises to our clients, partners, and communities. CIC Group is passionate about innovation, digital transformation, and inclusive insurance solutions that meet the evolving needs of cooperatives, SMEs, corporates, and individuals. By joining us, you will be part of a team that is shaping the future of financial protection across Africa.
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.
Why Join Us? Joining CIC Group as an Optometry Officer offers a compelling opportunity to extend your clinical expertise within a leading insurance and healthcare ecosystem. In this role, you will not only ensure accurate and timely adjudication of optical claims, but also influence cost optimization, provider quality standards, and value-based care through data-driven insights and clinical validation. You will operate at the intersection of healthcare delivery, fraud prevention, and customer experience—working with diverse stakeholders to enhance service efficiency and patient outcomes. If you are detail-oriented, analytical, and passionate about improving access to quality vision care while contributing to sustainable healthcare financing, CIC provides a dynamic platform for professional growth and meaningful impact.
If you have the aforementioned professional and academic qualifications and you are ready to execute the above mandate, strictly apply through: https://careers.cicinsurancegroup.com/ clearly indicating the position being applied for. The application should reach us by close of business on 15th April, 2026. Please note only short-listed candidates will be contacted. If you do not hear from us by 31st May, 2026 consider your application unsuccessful.
CIC Group is an equal opportunity employer and does not solicit or require any form of payment for employment opportunities.
CIC Group is an equal opportunity employer and does not solicit or require any form of payment for employment opportunities.
N/B: This job advert is open to both internal and external candidates.
