Clinical Care Specialist

3 weeks ago

Sandton, South Africa Discovery Ltd. Full time

**Business Unit**:Discovery Health**Function**:Clinical**Date**:21 Feb 2024**Key Purpose**
- To holistically review the needs of clinically complex members and coordinate their care in the most appropriate setting, liaising with internal and external stakeholders to ensure the best clinical outcomes.**Key Outputs**
- Perform health assessments on patients in order to identify individual patient risk factors
Perform interventions to influence individual patient risk
Promote behavior change to ensure greater treatment compliance and condition management
Authorising of admissions and treatment as per agreed protocols
Assist members with clinical related queries
Proactively assist complex member with understanding their plan benefits and maximizing their use to effect risk savings in the long term
Monitor patient progress through ongoing patient interaction and follow-up.
Co-ordination of integration of care including social services where appropriate.
Maintain relationships between key internal and external stakeholders
Refer to other departments where appropriate to ensure that the relevant benefits are provided**Competencies**

**The following competencies are required to be successful in the role**:

- Compassion: Genuinely cares about people; is concerned about their work and non-work problems; is available and ready to help; is sympathetic to the plight of others not as fortunate; demonstrates real empathy with the joys and pains of others.
Customer Focus: Is dedicated to meeting the expectations and requirements of internal and external customers; gets first-hand customer information and uses it for improvements in products and services; acts with customers in mind; establishes and maintains effective relationships with customers and gains their trust and respect.
Learning on the fly: Learns quickly when facing new problems; a relentless and versatile learner; open to change; analyzes both successes and failures for clues to improvement; experiments and will try anything to find solutions; enjoys the challenge of unfamiliar tasks; quickly grasps the essence and the underlying structure of anything.
Dealing with Paradox: Can act in ways that seem contradictory; is very flexible and adaptable when facing tough calls; can combine seeming opposites like being compassionately tough, stand up for self without trampling others, set strong but flexible standards; can act differently depending upon the situation; is seen as balanced despite the conflicting demands of the situation.**Requirements**:
**The following requirements are Essential**:

- Matric
Registered Nurse qualification or Enrolled Nurse (Enrolled nurse must have MCP or AIB experience)
Valid SANC registration
MS Office
At least 3 years clinical nursing experience, post training**The following requirements are advantageous**:

- Managed care experience
Discovery Health system knowledge and experience- EMPLOYMENT EQUITY
The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.

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