Specialised Health Care Coach

2 weeks ago


Bellville, Western Cape, South Africa Health Solutions Full time

Introduction


Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value.

We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by using a defined set of Health capabilities.


Role Purpose
To manage clinical risk of patients through the authorisation of clinically appropriate treatment and outbound interventions.

Requirements:

  • Matric
  • Nursing Diploma or Degree essential
  • Registered Nurse essential
  • Minimum of 4 years clinical experience essential
  • 2 years Mental Health / Psych experience essential
  • Registered with SANC essential
  • Experience in managed health care would be advantageous
  • Experience in the management of chronic diseases would be advantageous

Duties & Responsibilities

  • Liaising with patients, providers and Disease Management companies
  • Answering and assisting with all queries related to Mental Health programmes
  • Following up on decisions with Providers and/or 3rd parties
  • Monitoring the progress of patients on Mental Health programme
  • Maintaining relationships with 3rd parties
  • Assisting with early detection programmes and advocating available preventative health benefits to better manage risk
  • Facilitating reports to 3rd parties and the schemes
  • Initiating outbound contact with patients and providers where appropriate
  • Identifying and developing Clinical Guidelines and policies
  • Authorising appropriate and cost effective medical care and treatment
  • Participating in the identification of clinical guidelines
  • Researching, designing and developing material relevant to promoting awareness of health promotions e.g. Focus pages
  • Identifying all compliance risks
Educating and guiding all members regarding health care and their benefits

  • Supporting budget control and cost containment of health management programmes
  • Assisting with registration on various programmes to ensure quality of life for patients with life threatening diseases
  • Dealing promptly with client requests in a competent, efficient and professional manner
  • Liaising with specialists to gain their insight into assessing risks
  • Communicating with providers to improve the cost efficiencies of healthcare deliver

Competencies

  • Accountability
  • Planning
  • Organization and Attention to Detail
  • Customer orientation
  • Empathy
  • People skills
  • Teamwork and Cooperation
  • Business Administration
  • Results Orientation


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