Clinical Relationship Manager

2 weeks ago


Pretoria, South Africa H2R Africa Full time

**PLEASE ONLY APPLY IF YOU QUALIFY IN FULL. IF YOU DO NOT GET FEEDBACK WITHIN TWO WEEKS PLEASE CONSIDER YOUR APPLICATION TO BE UNSUCCESSFUL**.

Bachelor's degree in Business Administration and/ or Degree/Diploma in Nursing with management experience

Minimum 5-years experience within a healthcare provider liaison/ key account role within a managed healthcare/ medical scheme or medical sales environment

Excellent knowledge of pre-authorisation processes, healthcare service provider networks and other requirements within the medical scheme environment including but not limited to relevant legislation for g. the Medical Schemes Act

Valid drivers license
- Build and maintain relationships with all stakeholders (union groups, executives at contracted employer groups and healthcare service providers including hospitals and specialists)
- Establish and maintain productive, professional relationships with key personnel in assigned key customer accounts
- Establish and maintain a specialist healthcare provider network
- Coordinate and manage clinical service-related matters with all stakeholders
- Ensure clients expectations are met
- Coordinate the involvement of company personnel, including support, service and management of resources, in order to meet account performance objective
- Effective and holistic co-ordination of member care and management
- Perform site visits/ stakeholder contacts as required
- Attend to and resolve escalated member enquiries received from the various stakeholders within the agreed SLA
- Attend to general enquiries from healthcare service providers/members/employers/unions
- Handle all matters concerning assigned clients
- Administrative duties as required within the role
- Preparation of reports
- Remote benefit confirmation for any escalated pre-authorisation requests
- Effectively communicate with stakeholders, including members and healthcare service providers, re the outcome of pre-authorisation requests and/ or update of cases investigated
- Must be able to deliver quality relationships with all stakeholders
- Public speaking and presentation skills
- Negotiation skills
- Proficient with MS Office (Power Point, Excel, Word, Outlook)
- Self.motivated and the ability to work independently
- Excellent verbal and written communication skills
- Ability to manage high levels of pressure, demands and emotionally charged situations
- High degree of accuracy and attention to detail
- Administration and reporting skills
- Patient advocacy focus
- Must be willing to travel
- Must be able to maintain confidentiality
- Excellent time management



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