Consultant:disease Risk Management

1 month ago


Centurion, South Africa PPS Recruitment Full time

**Job Advert Summary**:
Applications are invited for the above-mentioned position, to be filled as soon as possible.

**Minimum Requirements**:
**Qualifications & Experience**
- Grade 12
- A Registered Nursing qualification
- Disease Risk Management is essential
- Sound knowledge of the Coding Systems: ICD10 & CPT4 Principles and sound knowledge of the Medical Aid Industry, Rules & Regulations, ISO and other related legislation
- Excellent business writing & communication skills with exceptional telephone etiquette
- Must have strong organisational awareness to anticipate the impact of actions on other groups.
- Time Management & good administration skills
- Effective conflict resolution skills and the ability to work under pressure
- Must be a strong team player and results driven
- Computer literacy (MS Office and Medical Administration system)

**Duties and Responsibilities**:

- Contacting of members and building of positive relationships with the members to achieve positive outcomes.
- Analyse and interpret reports, clinical results, and patient history information to provide an action plan per patient.
- Ensure adherence to Scheme Rules on all authorisations and clinical updates
- Effective handling of Internal/External Clinical Queries Communicate with members and service providers to address disease management matters
- Assist with Health Risk Management Monitoring & Management of hospital re-admissions
- Compile & submit detailed reports to the Scheme on costs and patient’s progress
- Support the Service Manager and HOD on any projects related to risk management.
- As a responsible employer, PPS encourages you to vaccinate and take the recommended vaccine boosters. The Company reserves the right to amend this stance, as and when required_.


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