Clinical Consultant

1 day ago

Centurion, South Africa Health Solutions Full time

**Introduction**
- Momentum Health Solutions, anentity of Momentum MetropolitanHoldings Limited deliverssustainable, integrated healthsolutions that meet the needs ofclients in different segments andmaximise lifetime client value. Webuild and maintain a culture ofinnovation, and create valuethrough unique insights of how toachieve specific outcomes byusing a defined set of Healthcapabilities.

**Disclaimer**
- As an applicant, please verify the legitimacy of this job advert on our company career page.

**Role Purpose**
- To ensure the implementation ofbest practices and optimal medicalcare for members through expert clinical guidance, collaborationwith healthcare professionals, andcontinuous improvementinitiatives.

**Requirements**:

- A nursing Diploma or Bachelor of Nursing Science.
- Additional qualifications such as Nurse Practitioner (NP), Clinical Nurse Specialist
- (CNS).
- Advanced Practice Nurse (APN),Certifications in critical care nursing, oncology nursing,paediatric nursing, or
other relevant specialties - (essential).
- Enrolled or Registered Nurse withSANC - (essential).
- 3 - 5 years of experience as aregistered nurse practitioner or equivalent experience.
- 3 - 5 years of experience within thehealthcare industry - (advantageous).
- 2 - 3 years of experience within themanaged care environment and/orhealthcare consulting
industry would be advantageous.

**Duties & Responsibilities**
- PROCESS
- Meet the daily key performance indicator for proactive communication with members,ensuring
timely assistance and effectively meeting their needs.
- Optimize bin management turn around time, streamlining the process for prompt issue resolution
and improving operational efficiency, in accordance with key performance indicator specifications.
adherence, resulting in improvedclarity and member satisfaction.
- Ensure appropriate control of benefits in and out of the hospitalby closely monitoring utilisation,
resulting in cost-effective care while maintaining quality outcomes.
requirements, ensuring fairness and accuracy in benefit coverage determinations.

CLIENT
- Maintain quality customer service by promptly addressing members' inquiries and concerns,
resulting in enhanced member satisfaction and trust.
- Build and maintain positive relationships with relevant stakeholders (e.g., hospitals and providers),
fostering effective collaboration and ensuring seamless coordination of care for members.

PEOPLE
- Appropriately refer cases to the case management team, ensuring members receive
comprehensive care coordination,resulting in improved healtho utcomes and member
satisfaction.
- Collaborate with the case management team, leveraging clinical expertise to support and enhance
their decision-making process,leading to optimal care plans and member well-being.

FINANCE
- Monitor and manage healthcareutilisation and costs, optimisingresource allocation and
maintaining financial sustainabilitywhile ensuring high-quality care.
- Identify cost-saving opportunitiesand process improvements,contributing to improved financial
efficiency and organisationaleffectiveness.

**Competencies**
- Analytical skills.
- Communication skills (written andverbal).
- Critical thinking skills.
- Decision-making skills.
- Interpersonal skills.
- Problem solving skills.
- Research skills.
- Organisational skills.
- Time management skills.
- Collaboration skills.

  • Senior Manager Clinical Consulting Services

    6 months ago

    Centurion, South Africa Affirmative Portfolios Full time

    **Medical / Emergency / Health / Lab** **Centurion - Gauteng** ***: **Senior Manager Clinical Consulting Services - Centurion** **Salary: R1,457,357.00pa CTC** **Overview**: The purpose of the job is to oversee the provision of Clinical services, administer the Prescribed Minimum Benefits (PMB) portfolio to ensure medical scheme members are protected and...

  • Senior Manager: Clinical Consulting Services

    7 months ago

    Centurion, South Africa Bontle consulting Full time

    The purpose of the job is to oversee the provision of Clinical services, administer the Prescribed Minimum Benefits (PMB) portfolio to ensure medical scheme members are protected and their entitlements are guaranteed, and to develop and implement the Prescribed Minimum Benefits regulation strategy. As a Senior Manager: Clinical Consulting Services you will...

  • Medical Writing Manager

    7 months ago

    Centurion, South Africa FHI Clinical Inc Full time

    **Summary of The Position**: The Medical Writing Manager is tasked with the writing of trial-related documentation for clinical projects undertaken by the Company in accordance with ICH GCP and local legal requirements, European, FDA and other international guidelines, as well as Company (and sponsor, if applicable) Procedural Documents. The Medical Writing...

  • Consultant: Clinical Auditor

    6 months 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**: - Nursing qualification. - Clinical Auditing experience - Minimum of 2 years' experience in the managed care environment **Duties and Responsibilities**: - Conduct clinical audits on claims and costs to ensure...

  • Specialist Clinical Reporting

    6 months ago

    Centurion, South Africa PPS Recruitment Full time

    **Job Advert Summary**: **Minimum Requirements**: - Grade 12 - Clinical qualification for example nursing - Data analytics qualification will be an advantage. - Industry/legislation and regulations essential - ISO Principles - Essential: Medical Scheme administration/managed Healthcare experience 3+ years - Essential: Reporting experience - Reporting...

  • Consultant

    6 months ago

    Centurion, South Africa Novasyte Full time

    P Purpose: - Provides high quality, on-time input to client projects in the life sciences field. Assignments range in complexity from primary market research, basic analysis and problem solving. Will serve as project leader for small teams or work streams. - Principal Accountabilities: - Assists with the review and analysis of client requirements or...

  • Clinical Trials Quality Assurance

    7 months ago

    Centurion, South Africa Novasyte Full time

    Job Overview Corrective and Preventative Action (CAPA) and Effectiveness Check (EC) plan review, approval and closure and Audit plan development. Provide consultation in interpretation of regulations, guidelines, policies, and procedures. Support management in promotion and assessment of compliance to regulations, guidelines and corporate policies,...

  • Senior Consultant: Management Consulting

    7 months ago

    Centurion, South Africa IQVIA Full time

    IQVIA South Africa has a great opportunity for a Senior MC Consultant position in our Commercial Solutions team based in Centurion. Responsible for the on-time completion of projects or components of large, complex projects for clients in the life sciences field. Identifies and elevates potential new business opportunities and assists in the sales...

  • Senior Consultant: Mc

    6 months ago

    Centurion, South Africa Novasyte Full time

    IQVIA South Africa has a great opportunity for a Senior MC Consultant position in our Commercial Solutions team based in Centurion. Responsible for the on-time completion of projects or components of large, complex projects for clients in the life sciences field. Identifies and elevates potential new business opportunities and assists in the sales...

  • Consultant Medical Management

    2 weeks ago

    Centurion, South Africa Six Sense Full time

    A well-established financial services business is seeking to appoint a Consultant Medical Management on a 3 year Fixed Term Contract Purpose of the job: The Consultant: Medical Management is responsible to implement the medical management activities, medical exception handling and providing administration support in claims processing. **Qualifications and...

  • Medical Advisor

    6 months ago

    Centurion, South Africa PPS Recruitment Full time

    **Job Advert Summary**: **Minimum Requirements**: Must be a Medical Doctor registered with Health Professions Council of South Africa (HPCSA). Medical indemnity insurance will be an added advantage. Must have sound knowledge of the Medical Aid Industry, Rules & Regulations, and other related legislation. Sound knowledge of PMB guidelines and Industry...

  • Coach : Hospital Benefit Managemant

    7 months ago

    Centurion, South Africa PPS Recruitment Full time

    **Job Advert Summary**: A new opportunity is open to an adaptable and people orientated team player, to provide on the job training and support to new clinical staff and coachees towards the enhancement of their skills in order to accomplish tasks optimally. **Minimum Requirements**: - Grade 12 certificate - A Registered Nursing qualification - A minimum...

  • Strategic Service Consultant: Life Sciences Industry

    1 month ago

    Centurion, Gauteng, South Africa IQVIA Full time

    Job SummaryWe are seeking an experienced Senior MC Consultant to join our Commercial Solutions team in Centurion. The ideal candidate will have a strong background in project management and a proven track record of delivering high-quality results in the life sciences industry.Key ResponsibilitiesParticipate or lead teams in the design, development, and...

  • Consultant Medical Management

    2 weeks ago

    Centurion, South Africa Six Sense Consulting Full time

    Qualifications and Experience: Bachelors Degree/Advanced Diploma in Health Sciences /Medical related qualification. Registration with HPCSA/SANCA Relevant 3 years experience in a Medical related environment Conduct medical assessment and compile injury assessment reports. Conduct assessments and bill reviews on submitted claims, focusing on the appropriate...

  • Senior Business Development Manager

    3 weeks ago

    Centurion, Gauteng, South Africa IQVIA Full time

    At IQVIA, we are seeking a Senior Consultant to join our Commercial Solutions team in Centurion. This exciting opportunity involves leading teams in the design, development, and delivery of consulting projects or components of larger, complex projects.We offer a competitive salary range of $120,000 - $180,000 per annum, depending on experience. If you...

  • Donor Care Officer

    2 months ago

    Centurion, South Africa South African National Blood Service Full time

    Job category: Health, Fitness, Medical and Optometry Location: Centurion Contract: Permanent Business Unit: Centurion Remuneration: R 426,864.00 EE position: No Introduction The position is to collect quality safe blood and blood products according to specific targets set per blood drive (fixed or mobile). Key Responsibilities 1. Manages cost per...

  • Strategic Business Development Manager

    4 weeks ago

    Centurion, Gauteng, South Africa IQVIA Full time

    IQVIA South Africa is currently seeking a Strategic Business Development Manager to join our Commercial Solutions team in Centurion. As a Senior Consultant: Management Consulting, you will be responsible for driving business growth and development through strategic partnerships and alliances.Estimated Salary: R1 200 000 - R1 800 000 per annumAbout the...

  • Eap Case Manager

    6 months ago

    Centurion, South Africa Health Solutions Full time

    **Introduction** Momentum Health Solutions (MHS), an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health and wellness solutions that meet the needs of clients in the different segments and maximize lifetime client value. We build and maintain a culture of innovation and create value through unique insights of how to achieve...

  • Coach : Integrated Care Management

    6 months ago

    Centurion, South Africa PPS Recruitment Full time

    **Job Advert Summary**: **Minimum Requirements**: - Have a grade 12 qualification - A Tertiary qualification will be an added advantage - Be able to develop a training needs analysis in line with our Performance Management System and ensure training interventions accordingly - Be able to transfer skills and knowledge - Develop and maintain Work Procedures...

  • 2 X Non-clinical Care Consultants

    2 months ago

    Centurion, South Africa PPS Recruitment Full time

    **Job Advert Summary**: **Minimum Requirements**: Grade 12 Bachelors Degree Mental Health 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...