Clinical Relationship Manager - Pretoria, South Africa - H2R Africa

H2R Africa

Verified Company

Pretoria, South Africa

3 weeks ago

Posted by:

Thabo Mthembu

beBee Recruiter

Description

PLEASE ONLY APPLY IF YOU QUALIFY IN FULL. IF YOU DO NOT GET FEEDBACK WITHIN TWO WEEKS PLEASE CONSIDER YOUR APPLICATION TO BE UNSUCCESSFUL.

Bachelor's degree in Business Administration and/ or Degree/Diploma in Nursing with management experience

Minimum 5-years experience within a healthcare provider liaison/ key account role within a managed healthcare/ medical scheme or medical sales environment

Excellent knowledge of pre-authorisation processes, healthcare service provider networks and other requirements within the medical scheme environment including but not limited to relevant legislation for g.

the Medical Schemes Act

Valid drivers license

Build and maintain relationships with all stakeholders (union groups, executives at contracted employer groups and healthcare service providers including hospitals and specialists)
Establish and maintain productive, professional relationships with key personnel in assigned key customer accounts
Establish and maintain a specialist healthcare provider network
Coordinate and manage clinical servicerelated matters with all stakeholders
Ensure clients expectations are met
Coordinate the involvement of company personnel, including support, service and management of resources, in order to meet account performance objective
Effective and holistic coordination of member care and management
Perform site visits/ stakeholder contacts as required
Attend to and resolve escalated member enquiries received from the various stakeholders within the agreed SLA
Attend to general enquiries from healthcare service providers/members/employers/unions
Handle all matters concerning assigned clients
Administrative duties as required within the role
Preparation of reports
Remote benefit confirmation for any escalated preauthorisation requests
Effectively communicate with stakeholders, including members and healthcare service providers, re the outcome of preauthorisation requests and/ or update of cases investigated
Must be able to deliver quality relationships with all stakeholders
Public speaking and presentation skills
Negotiation skills
Proficient with MS Office (Power Point, Excel, Word, Outlook)
Self.motivated and the ability to work independently
Excellent verbal and written communication skills
Ability to manage high levels of pressure, demands and emotionally charged situations
High degree of accuracy and attention to detail
Administration and reporting skills
Patient advocacy focus
Must be willing to travel
Must be able to maintain confidentiality
Excellent time management