Medical Quality Assurance Coach

4 months ago

Pretoria, South Africa Recruitforce Group Full time

or process knowledge gaps so that quality assurance outcomes and measures are achieved. He/ she will be responsible to train and coach staff based on the results of the quality measures and needs analysis - training may be done individually or within groups. **Qualifications**:

- Matric
- Business Management or Nursing diploma/ degree (SANC Registered)
- Accredited Certificate in Quality Management/ Quality Assurance and/ or Training

**Skills and Competencies Required**:

- Minimum 2-3 years’ experience in a similar role within a medical scheme environment.
- Advanced computer skills with a demonstrated ability to analyse data, system workflows and processes
- Proficiency with using MS SharePoint to share and manage documents and content, and to collaborate with team members.
- In-depth knowledge of Total Quality Management and an understanding of the differences between Quality Control and Quality Assurance.
- Excellent verbal and written communication skills.
- Excellent training/ coaching skills, including compilation and presentation of training materials.
- Knowledge of the South African Healthcare industry and prevailing legislation as well as coding structures i.e., ICD10’s, CPT4, NRPL, PMB conditions and clinical protocols
- Knowledge of pre-authorisation, case management and client service processes within a medical scheme.
- Ability to liaise with external (clinicians and healthcare facilities) and internal (colleagues across all service areas) parties.
- Self-motivator and the ability to work effectively in an independent environment.
- Excellent administrative skills.
- Good organisational and task prioritisation skills.
- Outstanding multitasking skills
- High degree of accuracy and attention to detail
- Compile and submit relevant reports in accordance with strict deadlines.
- Results orientated.

**Summary of Responsibilities**:

- Design and implement a standardised quality management system/ programme.
- Perform quality assurance reviews per user in accordance with an agreed schedule.
- Compile and analyse audit reports to identify trends requiring quality improvement and/ or staff training.
- Conduct necessary training and/or coaching in conjunction with the relevant departmental Team Leader.
- Plan and conduct internal quality audits and follow-up on corrective actions as needed.
- Conduct quality awareness sessions with all employees.
- Perform route cause analysis on escalations received and implement mechanisms, processes, and system changes to improve quality outcomes.
- Identify process, policy, or rule limitations that require intervention and/ or change.
- Keep senior management informed of any matters or developments pertaining to legislation that may
- Drive quality improvement initiatives across all services areas.

**Job Type**: Permanent

License/Certification:

- SANC (required)

Ability to Commute:

- Pretoria, Gauteng (required)

Ability to Relocate:

- Pretoria, Gauteng: Relocate before starting work (required)

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