Specialist Case Manager

3 weeks ago

Durban, South Africa Afrocentric Group Full time

Purpose Deliver and enable excellence in all service moments to all stakeholders (Members, Providers, Employer groups, Intermediaries, Schemes). Personalised clinical servicing through the Omni channel experience focusing on the overall care quality of interaction between our customers and the brand. Providing holistic care that is personalised and accessible, managing the care journey end to end. Experience Managed Healthcare Operations experience Operational 2 years Advantageous Specialised Clinical experience. (e,g, ICU, Neonatal, Renal, Psch, etc) Operational 2 - 3 years Essential Qualifications Bachelors Degree (3 years) / NQF level 7(Registered Nursing Qualification, plus registration with SA Nursing Council) Advantageous Diploma / NQF level 6(Registered Nursing Qualification, plus registration with SA Nursing Council) Position Specific KPA Manage Care Service Requests — Servicing all key stakeholders in the moment across all servicing channels as required until the clinical service request has been resolved. Educating stakeholders on self-help digital servicing tools. Connecting with your customers (all stakeholders) across all channels, enabling an intuitive experience bringing across our brand authentically. Providing a seamless, progressive and holistic approach, understanding the customer’s needs. Manage authorizations — Manage and or validate the customer’s authorizations needs with care, understanding and empathy. Caring holistically for the patient journey. Manage Cases — Manage clinical cases enabling a holistic personalised intervention. Caring holistically for the patient and their support structure journeys. Manage Excellent Experiences — Provide accurate and consistent information, meeting all quality standards and measures. Deliver excellence in customer satisfaction. Strive to identify areas of improvement and sharing of ideas with your team. Collaborate with all teams to enable peer to peer learning Drive Brand Loyalty — Being a brand ambassador, allowing the brand presence to be felt as an extension of the experience. Knowledge Advanced Health Care Industry Advanced Good understanding of the Health Care Environment and Facilities Advanced Health legislation and regulatory Basic Application of service processes Advanced Customer service Advanced Customer preferences and personality styles Technical Basic Microsoft Suite Basic use of technology Basic channel experience Turnaround Time The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of line managers. Our Commitment to Transformation AfroCentric is committed to transformation and embracing diversity. Our Employment Equity plan and targets will be considered as part of the recruitment process. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce, representative of the demographics of our society as well as people with disabilities. Should you not hear from us within a month of applying, consider your application unsuccessful . #J-18808-Ljbffr

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