Clinical Relationship Manager

4 months 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

  • Clinical Relationship Manager

    4 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...

  • Clinical Advisor Manager

    1 day ago

    Pretoria, Gauteng, South Africa Growthlink Consulting Full time

    Job Title: Clinical Advisor ManagerJoin Growthlink Consulting as a Clinical Advisor Manager and contribute to the success of our Medical Advisory Services team. As a key member of our team, you will be responsible for providing clinical expertise and guidance to support the development and implementation of medical schemes and healthcare policies.Key...

  • Clinical Case Manager

    3 weeks ago

    Pretoria, Gauteng, South Africa H2R Africa Full time

    Job Title: Clinical Case ManagerJob Summary: H2R Africa is seeking a highly skilled Clinical Case Manager to join our dynamic team. As a Clinical Case Manager, you will be responsible for managing the clinical appropriateness and risk of hospital events and associated healthcare services.Key Responsibilities:Clinical Coding: Perform clinical coding in...

  • Clinical Facilitator

    4 months ago

    Pretoria, South Africa Nurses on Call Full time

    Urgently looking for The Clinical Facilitator within Pretoria area to be responsible for the facilitation of teaching and learning of the theoretical and clinical component in a clinical environment to reinforce the learning process as well as the integration of theory and practice to reinforce the learning process. **Requirements**: Registered as a...

  • Clinical Advisor

    4 months ago

    Pretoria, South Africa The Aurum Institute Full time

    Work Description The Clinical Advisor is responsible for providing clinical advice and strategic direction to the to the support district/s and the appropriate internal and external clinical staff. They will building capacity among HCW to strengthen the TB HIV response and ensure clinical governance standards at all times. The position will assist the...

  • Clinical Advisor

    4 months ago

    Pretoria, South Africa The Aurum Institute Full time

    Work Description_ The Clinical Advisor is responsible for providing clinical advice and strategic direction to the to the support district/s and the appropriate internal and external clinical staff. They will building capacity among HCW to strengthen the TB HIV response and ensure clinical governance standards at all times. The position will assist the...

  • Clinical Case Manager

    1 week ago

    Pretoria, Gauteng, South Africa H2R Africa Full time

    {"title": "Case Manager", "description": "Job SummaryWe are seeking a skilled Case Manager to join our dynamic team at H2R Africa. As a Case Manager, you will play a critical role in managing the clinical appropriateness and risk of hospital events and associated healthcare services.Key ResponsibilitiesPerform clinical coding in accordance with CPT and ICD...

  • Clinical Case Manager

    7 days ago

    Pretoria, Gauteng, South Africa H2R Africa Full time

    {"title": "Case Manager", "description": "Job SummaryWe are seeking a skilled Case Manager to join our dynamic team at H2R Africa. As a Case Manager, you will be responsible for managing the clinical appropriateness and risk of hospital events and associated healthcare services.Key ResponsibilitiesPerform clinical coding in accordance with CPT and ICD...

  • Clinical Risk Manager

    3 days ago

    Pretoria, Gauteng, South Africa Oasis Healthservices Full time

    Job Title: Clinical Risk ManagerOasis Health Services is seeking a highly skilled Clinical Risk Manager to join our team. As a key member of our patient services department, you will be responsible for managing the financial and clinical risks of patients in our general ward.Key Responsibilities:Ensure accurate coding and clinical updates to achieve...

  • Research Audiologist

    2 weeks ago

    Pretoria, Gauteng, South Africa Rad Resources Full time

    Clinical Researcher - Audiology **Job Summary** We are seeking a highly skilled Clinical Researcher to join our team at Rad Resources. As a Clinical Researcher, you will be responsible for designing and implementing audiological research projects, as well as working with clinical and non-clinical colleagues to achieve research aims and clinical...

  • Clinical Auditor/senior Clinical Auditor

    3 months ago

    Pretoria, South Africa Careforce recruitment Full time

    Our client, a medical aid scheme in Pretoria are currently looking for a **Clinical Auditor/Snr Clinical Auditor. **This is a full-time hybrid position, and it will be expected of the successful individual to work at the office at least 3 days a week. About the role: To conduct clinical/coding audits according to the established internal, IIA and ISACA...

  • Clinical Advisor Manager

    3 weeks ago

    Pretoria, Gauteng, South Africa Growthlink Consulting Full time

    Job DescriptionJob Title: Clinical Advisor ManagerJob Summary:Growthlink Consulting is seeking a highly skilled Clinical Advisor Manager to join our team. The successful candidate will be responsible for providing clinical guidance and support to our clients in the healthcare industry.Key Responsibilities:Manage the administrative function in the Medical...

  • Clinical Auditor/snr Clinical Auditor

    4 months ago

    Pretoria, South Africa Careforce Recruitment Full time

    Our client, a medical aid scheme in Pretoria are currently looking for a Clinical Auditor/Snr Clinical Auditor. This is a full-time hybrid position, and it will be expected of the successful individual to work at the office at least 3 days a week. About the role: To conduct clinical/coding audits according to the established internal, IIA and ISACA...

  • Clinical Nursing Assistant

    3 months ago

    Pretoria, South Africa iMedrecruit Full time

    About the job Clinical Nursing Assistant / Clinical Technician A specialist Physician based in a private practice in Pretoria, is looking for a clinical nursing assistant or a clinical associate/technician who can perform general administrative duties, reception cover and basic clinical duties> **Requirements (but not limited to)**: - Diary and...

  • Clinical Case Manager for Spinal Management Program

    2 weeks ago

    Pretoria, Gauteng, South Africa H2R Full time

    Job Title: Clinical Case Manager for Spinal Management ProgramH2R is seeking a highly skilled Clinical Case Manager to join our team in the Spinal Management Program. As a key member of our team, you will be responsible for managing the access, clinical appropriateness, and risk of all requests for services related to back and neck pain management, spinal...

  • Clinical Case Manager for Spinal Management Program

    2 weeks ago

    Pretoria, Gauteng, South Africa H2R Africa Full time

    Job Title: Clinical Case Manager for Spinal Management ProgramH2R Africa is seeking a highly skilled Clinical Case Manager to join our team in the Spinal Management Program. As a key member of our team, you will be responsible for managing the access, clinical appropriateness, and risk of all requests for services related to back and neck pain management,...

  • Senior Manager Clinical Consulting Services

    3 months ago

    Pretoria, South Africa Thusa Batho Labour Solutions 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...

  • Clinical Nurse Assistant

    3 months ago

    Pretoria, South Africa iMedrecruit Full time

    A specialist Physician based in a private practice in Pretoria, is looking for a clinical nursing assistant or a clinical associate/technician who can perform general administrative duties, reception cover and basic clinical duties> **Requirements (but not limited to)**: - Diary and appointment management when required. - Assistance with ECG's, stress...

  • Senior Manager: Clinical Consulting Services

    3 months ago

    Pretoria, South Africa Future Africa Consulting (Pty)Ltd 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...

  • Senior Manager: Clinical Consulting Services

    5 months ago

    Pretoria, South Africa Nambiti Technologies Full time

    We are recruiting for a Senior Manager Clinical Consulting Services. - Driving the implementation of Clinical Consulting Services planned activities and projects: - Oversee the functioning of the Clinical Consulting Services sub-division by managing the sub-division projects and day to-day function of the Clinical unit including performance management,...