Clinical - Programme Coordinaator - Middelburg, South Africa - Careforce Recruitment

Careforce Recruitment
Careforce Recruitment
Verified Company
Middelburg, South Africa

1 week ago

Thabo Mthembu

Posted by:

Thabo Mthembu

beBee Recruiter
Description
Our client, a managed care organisation is looking for a Health-Programme Coordinator.

This is an equal opportunity organisation with various businesses and/ or subsidiaries that service clients in the medical scheme and insurance industries.


Position:
Clinical-Programme Coordinator


Reporting to:
Scheme Medical Advisor


Location:
On-site, Middelburg - MPU (No hybrid work)

Working hours:
Weekly rotation - 07H00 to 16H00 or 08H00 to 17H00 (Monday to Friday) Telephonic standby every third week


Qualifications:

  • Registered Nurse
  • Valid SANC registration

Skills, Competencies, and Experience:

  • Seven or more years' experience as a senior in a hospital setting.
  • Experience as a Wellness nurse within a retail pharmacy/wellness service provider will be advantageous.
  • Experience within a medical scheme/managed care organisation will be advantageous.
  • Legal knowledge, i.e. Medical Schemes Act, POPIA, medical liability, etc.
  • Knowledge of the South African Healthcare industry coding structures i.e. ICD10, CPT4, NRPL, PMB conditions and clinical protocols, etc.
  • Extensive clinical knowledge related to all aspects of patient management, including home care.
  • Excellent telephonic and written communication skills (will be tested).
  • Computer literacy, MS Office especially intermediate knowledge of Excel (will be tested) and experience with an industry information system (e.g. hospital, medical scheme administration, or managed care).
  • Proficiency in English and Afrikaans verbal and written.
  • Strong organisational and task prioritization, and multitasking skills.
  • Ability to research and analyse information.
  • Maintaining confidentiality of information.
  • Decisionmaking skills.
  • Following through on commitments.
  • Flexibility to travel.
  • SA valid driver's license.
  • High degree of accuracy and attention to detail.
  • Selfmotivator and the ability to work effectively independently.
  • Show initiative.
  • Demonstrated ability to deal with emotionally charged and stressful situations effectively.
  • Compassionate and attentive listener must be able to interact with the family/ loved ones of members with longstay hospital events and members with complex disease profiles, including but not limited to chronic conditions, oncology, mental wellness, etc
  • Must be confident and comfortable with clinical decisionmaking.
  • Summary of Responsibilities:
  • Confidential management of patient medical conditions, treatment, and funding information.
  • Driving riskbased preventative intervention and care thorough the Schemes model and programmes, including health risk assessments (HRA's), hospital and home visits and assessments.
  • Clinical coding per CPT4 and ICD10 requirements and as per client standards.
  • Managing patient hospitalisation; including the receipt and verification of hospital clinical updates, coordinating the appropriate Level of Care (LOC) and Length of Stay (LOS), and contain hospital stay financial risk (discharge planning).
  • Provide continuous, complete, and accurate updates and discharge information.
  • Review the costs to ensure costeffective and necessary care; balance cost and effectiveness of treatment to optimise access to care and facilities.
  • Keep the medical advisor/s, scheme management, providers, and members informed, including the interpretation of medical reports, facilitating clinical decisionmaking, and the efficient escalation of challenging and unresolved cases including reporting.
  • Interact with service providers relating to funding levels and updates.
  • Manage patient chronic conditions through the active disease management programmes.
  • Telephonic and written contact with all stakeholders, including but not limited to members, healthcare providers and the client.

On Offer:
Market related Cost to Company (CTC) based on experience and qualifications. CTC includes Medical Aid and Pension Fund.


Ability to Commute:

  • Middelburg, Mpumalanga (required)

Ability to Relocate:

  • Middelburg, Mpumalanga: Relocate before starting work (required)
Application Deadline: 2024/02/16
More jobs from Careforce Recruitment
See all jobs of Careforce Recruitment