Case Management Specialist

4 weeks ago

Sandton, South Africa Coloplast Full time

**Location**:
Sandton, ZA

**Job Family**: Consumer

**Country/Region**: South Africa

Case Management Specialist
- making sure our users get the best possible care

If you believe that when an individual with an intimate health care need reaches the optimum level of wellness and functional capability, then everyone benefits; the role of Case Management Specialist at Coloplast may be the perfect fit for you

Coloplast is a leading MedTech company that develops products and services that make life easier for people with intimate healthcare needs. We have embarked on a consumer-focused journey to get even closer to the consumers of our products, hence the need to make sure that we provide the best support possible when it comes to Case Management and funding of these products through various Medical Aid Schemes.

As Case Management Specialist, you would form an integral part of the consumer journey by facilitating the collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet Coloplast user’s health needs through communication and available resources to promote user safety, quality of care, and the best possible patient outcomes.

When joining Coloplast you will enter a truly global company that offers great challenges, opportunities and rewards. Reporting to the Service Marketing Manager for South Africa & Sub-Sahara, you will be situated in our new Sandton based office, together with the local HQ team.

Your key responsibilities

Coloplast user advocacy

Work cross-functionally to ensure smooth end-to-end authorization for Ostomy and Incontinence users that delivers an optimal consumer experience;
Create a clear set of guidelines that educates consumers and users on their condition, their treatment options and their Medical Scheme benefit limit and rules;
Help users navigate our local health care system, connecting them with community resources, orchestrating multiple facets of health care delivery, and assisting with administrative and logístical tasks;
Provide guidance on early case strategy and the appropriate pathway for future management i.e. settlement or investigation.

Relationship building with internal and external stakeholders

Own and create the relationship with Medical Aid Schemes and HealthCare professionals in South Africa to ensure close collaboration for improved patient outcomes;
Acting as a technical expert for the team, by reviewing and dealing with complex, challenging and sensitive case management issues when it comes to user’s needs.

Reporting and tracking

Map the existing case management processes with a view to building a more robust model and establishing SOP’s in line with business priorities;
Implement Case Management controls for tracking and feedback to our users and our internal team;
Agree to clear KPI’s, and drive performance management against those KPIs.

Forward thinking and innovation

Monitoring and gaining an understanding of the evolution of medical aid plans and collaborating with key stakeholders in the financial management of treatments;
Market access strategy and mitigation of risks related to health spend;
Review Treatment plans on a case by case basis, within the bounds of protocols and guidelines;
Education and Experience Criteria

High school diploma or equivalent required;
Minimum education of Bachelor’s Degree;
Minimum 5 years’ experience in a funding or managed care related environment;
Relevant experience in case management with a key understanding of the funder landscape within South Africa is crucial.

Pursuing an ambitious growth agenda, Coloplast develops and markets products and services that make life easier for people with intimate healthcare needs. Employing about 14.000 people and with products available in more than 143 countries, we are one of the world´s leading medical device companies. We are constantly growing our business and always looking for new ways to move forward - we explore, learn and look for new ways of doing things.

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