Salary : R
Location :
Position Purpose:
To provide information, advice, and explanations on clinical outcomes or systems of a complex clinical nature or to resolve complicated process challenges. Ensure the effective use of relevant healthcare benefits and systems to optimize targeted communication interventions telephonically and digitally. This role aims to achieve GEMS disease management outcomes according to clinical guidelines.
Key Responsibilities:
Continuous Improvement
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- Implement practical solutions using specialist and departmental systems and processes.
- Provide specialist input and recommendations to improve efficiency, compliance, and quality objectives.
- Identify problems and propose solutions to present to appropriate leaders or stakeholders.
- Ensure day-to-day operational support required from the area of specialization is provided to enhance performance.
Cost Containment
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- Support the identification, development, and implementation of cost-effective processes to increase efficiency and reduce cost drivers.
- Continuously review cost/benefit and Return on Investment within the area of specialization.
Drive Customer-Centricity
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- Maintain a high level of impact on other departments to support improved delivery.
- Continually increase understanding of client and stakeholder needs, satisfaction, and service delivery.
Knowledge Management
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- Ensure adequate knowledge regarding specialization is shared as required and maintained within the research library.
- Provide advice and/or training as required.
- Maintain, develop, and implement specialist knowledge within the day-to-day operations of the organization.
Maintain Expertise Level
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- Be a member of related professional bodies.
- Ensure CPD (continual professional development) or similar accreditation requirements are met annually to ensure maintained specialist accreditation.
Network Key Relationships
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- Engage with and provide support to the established network of internal and external expert resources and partners.
Specialist Support to Projects
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- Provide specialist expertise and ensure best practices related to specialization are implemented in projects when required.
- Conform to project management disciplines when participating in projects.
- Represent the department or project on appropriate committees related to the area of specialization.
Minimum Requirements:
- Grade 12 / Matric / NQF level 4 (Essential)
- Minimum 5 years managed healthcare experience. Comprehensive knowledge of scheme rules, operational clinical processes, and systems is essential. Knowledge of internal business processes.
- Relevant clinical qualification (registered nurse or pharmacist)
Qualities and Skills:
Attributes:
- Collaboration: Build work-related networks and share knowledge with colleagues – Building networks.
- Credibility: Lead with integrity and trust others as you would like to be trusted – Living the values and being transparent.
- Ownership: Make critical decisions based on what’s right for the employer and Customers – Owning operational decisions and knowing oneself.
- Influence: Engage with Customers and colleagues to advance the organization’s welfare – Making work happen.
- Entrepreneurship: Take chances to continuously improve our Customer’s experiences – Driving operational efficiencies.
Computer Literacy: Advanced proficiency in computer literacy and applications.
Knowledge: Knowledge of IT systems and products, knowledge of scheme rules and contractual negotiations, knowledge and application of processes and procedures, knowledge and application of relevant legislation.
Technical: Microsoft Suite, using technology comfortably, channel experience.
Skills: Data modeling and evaluation, Adobe Creative Suite, task management, computer technology skills, communication skills, business writing skills, knowledge and application of systems and processes, attention to accuracy and detail, problem-solving and decision-making skills, customer focus, numerical ability.
Application Deadline: 31st March 2024