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Clinical Relationship Manager

5 months ago


Pretoria, South Africa H2R Full time

Gauteng, Tshwane (Pretoria)
- Market related - Market related Monthly Cost To Company (Market related)

Our client, in the Medical Industry has a permanent vacancy in for a client Relationship Manager.

Th Company is an equal opportunity organisation with various businesses and/ or subsidiaries that service clients in the medical

scheme and insurance industries. The Group requires the services of an experienced Clinical Relationship (Key Accounts) Manager to join their dynamic team.

The purpose of the position is to effectively engage and develop mutually beneficial relationships with healthcare service providers and other stakeholders within the healthcare servicing continuum who provide care and/ or services to the beneficiaries of our contracted medical schemes. The successful incumbent must be able to translate the business strategy into the business practice and servicing modalities through the effective use and implementation of best practices principles; setting and achieving company objectives; and the analyses and interpretation of various clinical data elements to continuously and pro-actively ensure service delivery improvement.

**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 driver’s 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

For more information please contact:

- Dawn Hamer