Talentpool - Care Navigator - Sandton, South Africa - Discovery Ltd.

Discovery Ltd.

Verified Company

Sandton, South Africa

1 week ago

Posted by:

Thabo Mthembu

beBee Recruiter

Description

Business Unit:
Discovery Health
Function:Call Center / Contact Center
Date:8 Jun 2023
Talentpool - Care Navigator

About the Department

The Discovery Care Coordination team works alongside Healthcare professionals on the Discovery Care Coordination Network to improve the clinical outcome for our diabetic members.
Key Purpose
The Care Navigators role is to assist members to understand and navigate their specific benefits relating to their diabetes and cardio metabolic comorbidities to enable access to the full basket of care as well as to enable members to manage their health and provide an exceptional member experience**Areas of responsibility may include

- but is not limited to**:

Induct new members onto the programme: explain the terms and conditions, providing benefit education and support, enrolment onto Condition Management and activation of Vitality modules if applicable
Inbound query resolution member and provider
Ensure benefits are adhered to and explained: e.g. 1 out of network GP claims, claims relating to referrals from a doctor other than the primary treating provider
Referral follow up and adherence monitoring
Ad hoc member and provider outbound campaigns (e.g., Vitality Active Rewards Campaign, Diabetes Care SMS Campaign)
Achieve department metrics (TWT, MBR, DPMO, Production etc)
Adhere to and continually contribute to the refinement of all relevant SOP's e.g. escalations, Exact etc.

Personal Attributes and Skills

An unrelenting commitment to excellence with a drive to exceed expectations;
Exceptional analytical and problem solving skills;
An ability to deal with ambiguity and continuous change, taking a rollupthesleeves, dowhateverisnecessary approach;
A passion for personal development and growth with a high learning potential;
Sophisticated written and verbal communication skills for executivelevel internal and external delivery;
Strong interpersonal skills and diplomacy with a people and relationship orientation;
Experience in leading and managing complex, multistakeholder projects;
Ability to work calmly under pressure and provide answers and direction to others; and
Creative thinking and the ability to operationalise innovation.

Reports to

Team leader DCC
Personal Attributes and Skills
Empathy and ability to communicate well
Tenacity
Stress Management
Persuasion
Client orientation
Ability to adapt easily to changing circumstances as the job functions constantly change depending on business requirements
Ability to work well within a team as well as independently

Education and Experience

Matric
Minimum 1 year CIB experience
Product and process knowledge

Employment Equity

The Company's approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.

EMPLOYMENT EQUITY
The Company's approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.