Current jobs related to Coordinator: Member Care - Pretoria, Gauteng - Careforce Recruitment

  • Unit Leader

    3 weeks ago

    Pretoria, Gauteng, South Africa National Renal Care Full time

    About National Renal CareNational Renal Care is a leading healthcare organization that provides comprehensive kidney disease management services. Our mission is to deliver high-quality, patient-centered care that exceeds expectations.Job SummaryWe are seeking an experienced and skilled Unit Leader to join our team. The successful candidate will be...

  • Care Activities Coordinator

    6 days ago

    Pretoria, Gauteng, South Africa Guardian Healthcare Full time

    About the RoleWe are seeking a highly motivated and compassionate Activities Coordinator to join our team at Guardian Healthcare. As an Activities Coordinator, you will play a vital role in creating and delivering engaging activities and events that promote the independence and well-being of our residents.Our residents are at the heart of everything we do,...

  • Care Activities Coordinator

    6 days ago

    Pretoria, Gauteng, South Africa Guardian Healthcare Full time

    About the RoleWe are seeking a highly motivated and compassionate Activities Coordinator to join our team at Guardian Healthcare. As an Activities Coordinator, you will play a vital role in creating and delivering engaging activities and events that promote the independence and well-being of our residents.Our residents are at the heart of everything we do,...

  • Care and Activities Coordinator

    10 hours ago

    Pretoria, Gauteng, South Africa Gateway Full time

    About the RoleWe're seeking a dedicated and passionate Activities Coordinator to join our team at Charlton Kings. As an Activities Coordinator, you'll play a vital role in creating and delivering engaging activities and events that promote independence and enhance the lives of our residents.Our homes are vibrant and joyful communities, and we're committed to...

  • Disease and Care Coordinator

    3 weeks ago

    Pretoria, Gauteng, South Africa H2R Africa Full time

    About the Role:H2R Africa is seeking a highly skilled and experienced Disease and Care Coordinator to join our dynamic team. As a Disease and Care Coordinator, you will play a critical role in providing active disease management, clinical care support, coaching, and health education services to our clients who are registered for, and living with one or more...

  • Care Home Administrator

    3 weeks ago

    Pretoria, Gauteng, South Africa Gateway Full time

    About the Role:We are seeking a highly skilled and experienced Care Home Administrator to join our team at Gateway. As a key member of our administrative team, you will play a vital role in ensuring the smooth operation of our care home.Key Responsibilities:Manage the provision of effective and efficient reception services, ensuring a warm and welcoming...

  • Care Home Administrator

    10 hours ago

    Pretoria, Gauteng, South Africa Gateway Full time

    Care Home Administrator Job DescriptionWe are seeking a highly skilled and motivated Care Home Administrator to join our team at Gateway. As a key member of our administration team, you will play a vital role in ensuring the smooth operation of our care home.Key Responsibilities:Manage the reception services, providing a warm and welcoming experience for...

  • Care Worker

    2 days ago

    Pretoria, Gauteng, South Africa Gateway Full time

    We are seeking a dedicated and compassionate individual to join our team at Gateway as a Care Assistant. As a key member of our care team, you will play a vital role in ensuring the highest possible level of care is provided to our residents during the night.Main Responsibilities:Personal Care and Support: Assist residents with their personal care needs,...

  • Care Assistant

    6 days ago

    Pretoria, Gauteng, South Africa Workforce Group Full time

    We are seeking a dedicated and compassionate individual to join our team as a Care Assistant. As a key member of our care team, you will play a vital role in ensuring the highest possible level of care is provided to our residents during the night.Main Responsibilities:Assisting residents with personal care and continence needs, ensuring their dignity and...

  • Unit Leader

    1 week ago

    Pretoria, Gauteng, South Africa National Renal Care Full time

    Job SummaryNational Renal Care is seeking a highly skilled and experienced Unit Leader to join our team. As a key member of our healthcare team, you will be responsible for coordinating improved quality nursing care and ensuring compliance to professional and ethical practice.Key ResponsibilitiesEnsure growth of the business through effective marketing,...

  • Caregiver for Elderly

    6 days ago

    Pretoria, Gauteng, South Africa National Renal Care Full time

    About the RoleWe are seeking a compassionate and dedicated individual to join our team as a Caregiver for Elderly residents in our care home. As a key member of our team, you will play a vital role in providing high-quality care and support to our residents.Key ResponsibilitiesProvide personal care and support to residents, including bathing, dressing, and...

  • Care Engagement Specialist

    2 days ago

    Pretoria, Gauteng, South Africa Gateway Full time

    About the RoleWe're seeking a talented Activities Co-ordinator to join our team at Charlton Kings. As a key member of our community, you'll play a vital role in creating a vibrant and joyful atmosphere for our residents.Key ResponsibilitiesDevelop and deliver engaging activities and events that cater to the diverse needs and interests of our residents.Build...

  • Caregiver for Elderly

    7 days ago

    Pretoria, Gauteng, South Africa National Renal Care Full time

    About the RoleWe are seeking a compassionate and dedicated individual to join our team as a Caregiver for Elderly. As a key member of our care home, you will play a vital role in providing high-quality care and support to our residents.Key ResponsibilitiesProvide personal care and support to residents, promoting their dignity and well-beingAssist with daily...

  • Healthcare Case Coordinator

    3 weeks ago

    Pretoria, Gauteng, South Africa MediHelp Full time

    Position: Healthcare Case CoordinatorLocation: Tshwane Metro, Pretoria, BrooklynEmployment Type: Permanent, Full-TimeIndustry Focus: Insurance and HealthcareKey Responsibilities:Organize and streamline daily operations to ensure timely updates on patient cases within an 8-hour timeframe.Monitor long-term and high-cost cases for hospitalized and home care...

  • Care Engagement Specialist

    1 day ago

    Pretoria, Gauteng, South Africa Gateway Full time

    About the RoleWe're seeking a talented Activities Co-ordinator to join our team at Charlton Kings. As a key member of our community, you'll play a vital role in creating a vibrant and joyful atmosphere for our residents.Key ResponsibilitiesDevelop and deliver engaging activities and events that cater to the diverse needs and interests of our residents.Build...

  • Intensive Care Unit Registered Nurse

    1 week ago

    Pretoria, Gauteng, South Africa People Dimension Full time

    Job SummaryWe are seeking a highly skilled and experienced ICU Registered Nurse to join our team at People Dimension. As a critical care nurse, you will be responsible for delivering high-quality patient care to critically ill patients in our Intensive Care Unit.Key ResponsibilitiesPatient Care: Provide comprehensive and quality patient care to meet the...

  • Intensive Care Unit

    2 weeks ago

    Pretoria, Gauteng, South Africa People Dimension Full time

    Job SummaryWe are seeking a highly skilled and experienced Intensive Care Unit (ICU) Nurse to join our team at People Dimension. The successful candidate will be responsible for providing high-quality patient care to critically ill patients in our ICU department.Key ResponsibilitiesPatient Care: Deliver comprehensive and quality patient care to meet the...

  • Healthcare Case Coordinator

    3 weeks ago

    Pretoria, Gauteng, South Africa MediHelp Full time

    Job Title: Case Manager - Medical AidLocation: Tshwane Metro, Pretoria, BrooklynJob Type: Permanent, Full-TimePrimary Industry: InsuranceSecondary Industry: Health, Medical and relatedKey Responsibilities:Organize and prioritize daily activities to ensure timely updates on patient cases within the required turnaround time.Monitor and follow up on long-term...

  • Healthcare Case Coordinator

    3 weeks ago

    Pretoria, Gauteng, South Africa MediHelp Full time

    Job Title: Case Manager - Medical AidLocation: Tshwane Metro, Pretoria, BrooklynJob Type: Permanent, Full-TimePrimary Industry: InsuranceSecondary Industry: Health, Medical and relatedKey Responsibilities:Organize and prioritize daily responsibilities to ensure timely updates on patient cases.Monitor and follow up on long-term and high-cost cases involving...

  • Customer Care Specialist

    3 weeks ago

    Pretoria, Gauteng, South Africa NTT DATA Full time

    Job OverviewMake a Difference with NTT DATANTT DATA is a leading provider of digital and AI infrastructure, and we're looking for a skilled Customer Care Specialist to join our team. As a key member of our service desk, you'll be responsible for providing exceptional support to our clients, ensuring their technical issues are resolved efficiently and...

Coordinator: Member Care

3 months ago

Pretoria, Gauteng, South Africa Careforce Recruitment Full time

Position:
Coordinator: Member Care (Pre-authorisations)

Reporting to:
Contact Centre Operational Manager

Location:
On-site at the Head Office, Pretoria
-
You will be required to work shifts between 7h00 and 19h00 (Monday to _
-
Sunday)_

Qualifications:

  • Registered/ Enrolled Nurse
  • Valid registration with SANC

Skills and Competencies Required:

  • Minimum 23 years' experience in a similar role within a managed healthcare or medical scheme environment
  • Sound knowledge of the South African Healthcare industry and prevailing legislation, current coding structures i.e. ICD10's, CPT4, NRPL, PMB conditions and clinical protocols
  • Thorough, wellgrounded clinical knowledge of the preauthorisation of hospital admissions (including Length of Stay and Level of Care), inrooms procedures and other healthcare services requiring preauthorisation
  • Excellent telephonic and written communication capability within a call centre environment _(will be tested)_
  • Computer literate _(will be tested) _
  • MIP Application System experience will be advantageous
  • Customer service orientation
  • Ability to liaise with external parties clinicians and members and to make decisions
  • Demonstrated ability to effectively deal with emotionally charged and stressful situations
  • Selfmotivator and the ability to work effectively in an independent environment
  • Good organisational and task prioritisation skills
  • Outstanding multitasking skills
  • Proficiency in English written and verbal _(an additional language will be_
- advantageous)_

  • Ability to research and analyse information
  • High degree of accuracy and attention to detail
  • Compile and submit relevant reports in accordance with strict deadlines
  • Results orientated
  • Maintaining confidentiality of information

Summary of Responsibilities:

  • Attend to incoming calls from healthcare service providers and members/ beneficiaries
  • Verification of the eligibility of cover within available benefits as per scheme rules, clinical protocols, and funding guidelines
  • Strict adherence to benefits, scheme rules, clinical protocols and funding guidelines across all services and authorisation categories
  • Clinical Risk Management to reduce the risks associated with hospital and other authorised services
  • Establish the presence of any comorbid conditions from the caller or beneficiary if caller is not able to assist
  • Refer to member management if comorbid conditions are present for intervention and followup
  • Attend to general enquiries
  • Prepare and present cases for escalation to member management for discussion and resolution
  • Provide member care and education to patients with and without chronic conditions who need to participate in any of the registered active disease management programs.


Should you be interested in this position, and you meet the requirements, please send your CV, copies of SANC Registration, Certificates and Payslip.


Ability to commute/relocate:

  • Pretoria, Gauteng: Reliably commute or planning to relocate before starting work (required)
Application Deadline: 2023/08/25