Clinical Specialist

6 months ago

Durban, South Africa Health Solutions Full time

**Introduction**
- Through our client-facing brands Metropolitan and Momentum, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables businesses and people from all walks of life to achieve their financial goals and life aspirations.We help people grow their savings, protect what matters to them and invest for the future. We help companies and organisations care for and reward their employees and members. Through our own network of advisers or via independent brokers and utilising new platforms Momentum Metropolitan provides practical financial solutions for people, communities, and businesses.

**Role Purpose**
- Accountable for clinical risk management processes, operationalizing process improvements, interpreting requirements from various stakeholders and collaboratively constructing meaningful conceptual to implementation rules and data mapping requirements for BSS configuration and Business transformational efforts, ensuring that the business processes and system capabilities are aligned to service delivery.**Requirements**:
**QUALIFICATIONS**
- Matric
- Qualification as a Registered Nurse and registered with SANC (Essential)
- Training or coaching qualification (Advantageous)

**EXPERIENCE**
- 3-5 years operational experience (Essential)
- 3-5 years of experience in Managed Health Care is essential (especially understanding the CMS requirements and standards associated with the Medical Schemes Act, Regulations and Guidelines and Accreditation Standards)
- Claims Assessing experience (Advantageous)

**ATTRIBUTES**
- Knowledge of the NHRPL (National Health reference Price List - previously known as BHF), SAMA tariffs, ICD10, CPT (CCSA) coding is advantageous
- Deep knowledge of the Medical Schemes Act and the relevant Regulations
- Sound communication skills (both Written & Verbal)
- Diversity and Inclusiveness
- Collaboration, Adaptability, Results driven
- Teamwork
- Proactive
- Ability to work under pressure
- Strong organisation skills
- Attention to detail and high level of accuracy
- Ability to multi-task

**Duties & Responsibilities**

**DEVELOP AN UNDERSTANDING OF INTERNAL ENVIRONMENT IN LINE WITH BUSINESS REQUIREMENTS**
- Internal Processes_

1. Engage business stakeholders regularly on key operational processes in regards to Products, Systems, Content and Processes that will improve business outputs
2. Review clinical and technical data and identify how better to structure the data collection requirements and processes. Analyse trends to develop rules set required to increase straight through processes.
3. Map data and implement more data collection requirements to enhance the data visualization outputs of value demonstration
4. Design content required for more skillful rule authoring requirements for operational and system processes.
5. Identify training needs of the greater business team and engage collaboratively to support business leaders to address the gaps
6. Conduct gap analysis and provide feedback to team members and managers throughout the process
7. Annual updating of department process documents and process library
9. Liaise with trainers to ensure that their training material is accurate and continuously updated
10. Deliver on service level agreements made with clients and internal and external stakeholders to ensure that client expectations are managed
11. Develop and maintain productive and collaborative working relationships with peers and stakeholders
12. Positively influence and participate in change initiatives
13. Continuously develop own expertise in terms of professional, industry and legislation knowledge

**ENABLE CLIENT CENTRICITY WITHIN AREA OF RESPONSIBILITY**
- Client Services_

1. Build and maintain relationships with clients and internal stakeholders
2. Deliver on service level agreements applicable to clients and internal and external stakeholders in order to ensure that client expectations are managed
3. Make recommendations to improve client service and fair treatment of clients within area of responsibility
4. Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service
5. Continuously monitor turnaround times and quality standards and resolve issues speedily to enhance client service delivery
6. Drive client service delivery goal achievement in line with predefined standards in order to ensure that clients receive appropriate advise and after sales service
7. Manage client query processes and ensure that queries are tracked, accurately resolved and used as a mechanism to improve client service and business processes

**SELF MANAGEMENT AND TEAMWORK**
- People_

1. Build strong relationships through providing specialist know-how and leadership to others, expressing positive expectations
3. Positively influence and manage change and offer specialist support where required
4. Contribute to continuo

  • Coastal Clinic Liaison Specialist

    2 weeks ago

    Durban, KwaZulu-Natal, South Africa Dis-Chem Pharmacies Full time

    About This OpportunityAs a Coastal Clinic Liaison Specialist at Dis-Chem Pharmacies, you will play a crucial role in supporting pharmacists with translating emerging developments and policies into practice for clinics. With your expertise, you will conduct regular clinic visits to identify operational improvement areas and consolidate pharmacy reports for...

  • Clinical Nurse Specialist

    6 months ago

    Durban, South Africa Durpro Workforce Solutions Full time

    The Operational Clinical Nurse Specialist focuses on the delivery of quality competent nursing care. The incumbent acts as a clinical resource and leader in the theatre environment, performing functions at an advanced level competently and consistently. **Key responsibilities**: - Operational management - Advanced clinical care - Consultation as a source...

  • Clinical Care Specialist

    4 weeks ago

    Durban, KwaZulu-Natal, South Africa HR Recruit Full time

    Job OverviewAs a Clinical Care Specialist at HR Recruit, you will play a vital role in providing exceptional patient care and ensuring the well-being of individuals under your supervision.

  • Clinical Claims Specialist

    4 weeks ago

    Durban, KwaZulu-Natal, South Africa Pillango Placements Full time

    Job OverviewPillango Placements is seeking a skilled Clinical Claims Specialist to join our team. This role will involve delivering high-quality administrative medical debt services to clients, ensuring timely and accurate claims processing, and building strong relationships with medical professionals.

  • Clinical Hospitalization Specialist

    3 weeks ago

    Durban, KwaZulu-Natal, South Africa Oasis Healthservices Full time

    Oasis Healthservices Job OpportunityAre you a skilled clinical professional looking to leverage your expertise in hospitalization management?We invite applications for a Clinical Hospitalization Specialist role at Oasis Healthservices.About the RoleAs a key member of our team, you will be responsible for applying clinical knowledge to justify patient...

  • Clinical Training Specialist

    6 months ago

    Durban, South Africa JOINT MEDICAL HOLDINGS-CITY HOSPITAL Full time

    **JOINT MEDICAL HOLDINGS PROPRIETARY LIMITED** Registration No. 2011/010448/07 **VACANCY: JOINT MEDICAL HOLDINGS** **DIVISION: JMH GROUP** **JOB TITLE: CLINICAL TRAINING SPECIALIST (THEATRE)** **PURPOSE OF POSITION** Responsible for the facilitation of teaching and learning of the theoretical and clinical component in a clinical environment to reinforce...

  • Clinical Facilitator

    6 months ago

    Durban, South Africa Ikho Direct Full time

    Our client a national private hospital group is looking to employ a RN - Clinical Facilitator - Critical Care to work at one of their hospitals. Qualifications & Experience; - Degree/Diploma in Nursing Science - Registered with South African Nursing Council - Minimum 3 years relevant experience as a clinical facilitator / specialist - Post basic specialty...

  • Clinical Training Specialist

    6 months ago

    Durban, South Africa HR Ingenuity Full time

    **PURPOSE OF POSITION** 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. **KEY PERFORMANCE AREAS** - The clinical training specialist will undertake activities designed to maximize nursing...

  • Clinical Nurse Specialist- Theatre

    3 months ago

    Durban, South Africa Netcare Umhlanga Hospital Full time

    The Clinical Nurse Specialist focuses on the delivery of quality competent nursing care. The incumbent acts as a clinical resource and leader in a particular clinical specialty, performing functions at an advanced level competently and consistently. Sound and contemporary knowledge of the area of specialty, together with an advanced understanding of...

  • Clinical Service Support Specialist

    3 weeks ago

    Durban, KwaZulu-Natal, South Africa Discovery Limited Full time

    Job OverviewWe are seeking a highly skilled Clinical Service Support Specialist to join our team at Discovery Limited in Durban, KwaZulu-Natal.About the RoleThis is an exciting opportunity for a motivated individual to deliver world-class service to our members, providers, and other stakeholders by resolving queries through various servicing channels.Key...

  • Clinical Application Specialist

    6 months ago

    Durban, South Africa Unique Personnel Full time

    Job Title - Clinical Application Specialist - Job Number - 70651 - Skills - MS Office - Industry - Medical Practice - City - eThekwini (Durban) - Job Description - Collaborate with healthcare professionals, patients, and caregivers to evaluate equipment needs based on individual requirements and conditions. - Recommend suitable equipment solutions to enhance...

  • Clinical Training Specialist

    6 months ago

    Durban, South Africa Mass Staffing Projects Full time

    **Job Information** - Location- Nursing Jobs in Durban- Salary- R420k - R320k- Job Type- Permanent- Education- B.Cur/Diploma in Nursing & Postgraduate Diploma in Nursing Education- Experience- +3 years experience within Clinical Facilitation/training- Reference- CTSDBN- - pharmacy.jobs(at)staffingprojects.co.za- Fax- 0866023398Are you looking to take the...

  • Clinical Nurse Specialist

    3 weeks ago

    Durban, South Africa Jobted ZA C2 Full time

    The CNS will play a pivotal role in delivering exceptional patient care, advancing nursing practices, and promoting professional development within the surgical environment. Key Requirements: - Nursing diploma or degree with post basic Operating Theatre diploma - Minimum of 2 years' experience in the Operating Theatre is essential. - Proven experience in...

  • Operational Clinical Nurse Specialist

    6 months ago

    Durban, South Africa Immploy Recruitment Full time

    Support the Unit Manager in ensuring that the Theatre is providing safe, cost effective quality patient carein line with the Clinical Governance strategy, evidence based practice and healthcare research. Acts as a shift coordinator. Responsible for the delivery and co-ordination of competent nursing care. Support group qualityimprovement initiatives that...

  • Clinical Consultant

    3 weeks ago

    Durban, KwaZulu-Natal, South Africa Discovery Limited Full time

    Job Overview">Detailed knowledge of clinical skills in the community setting is required for this position. As a Clinical Consultant, you will be responsible for providing high-quality care to patients in their own homes, focusing on timely treatment and early discharge. The ideal candidate will possess strong communication skills, the ability to work...

  • Specialist Mental Health Professional

    4 weeks ago

    Durban, KwaZulu-Natal, South Africa MSP Staffing LTD Full time

    About the RoleWe are seeking a dedicated Specialist Psychiatrist to join our esteemed specialist clinic in Underberg, KZN. If you are passionate about mental health and looking to make a meaningful difference in your community, this position may be an excellent fit.Key ResponsibilitiesProviding expert psychiatric care and treatment to patients with various...

  • Specialist Clinician Scientist: Paediatrician

    6 months ago

    Durban, South Africa South African Medical Research Council (MRC) Full time

    **HIV AND OTHER INFECTIOUS DISEASES RESEARCH UNIT** **(DURBAN OFFICE)** The South African Medical Research Council (SAMRC) strives to improve the nation’s health and quality of life by funding and conducting relevant and leading health research. It further aims to promote equity, career development and progression. **PAEDIATRICIAN (SPECIALIST CLINICIAN...

  • Registered Nurse/Clinical Technologist

    3 weeks ago

    Durban, South Africa National Renal Care Pty Full time

    Job title : Registered Nurse/Clinical Technologist (Independent Practice)- BRC Gateway (Durban North)Job Location : KwaZulu-Natal, DurbanDeadline : December 11, 2024Quick Recommended Links Jobs by Location Job by industries RequirementsRequirements and Experience Relevant qualification within a specialist area or equivalent NQF 7. Registration with the...

  • Registered Nurse/Clinical Technologist

    2 weeks ago

    Durban, South Africa National Renal Care Pty Full time

    Job title : Registered Nurse/Clinical Technologist (Independent Practice)- BRC Gateway (Durban North) Job Location : KwaZulu-Natal, Durban Deadline : December 11, 2024 Quick Recommended Links Jobs by Location Job by industries RequirementsRequirements and Experience Relevant qualification within a specialist area or equivalent NQF 7. ...

  • Dialysis Care Specialist

    2 weeks ago

    Durban, KwaZulu-Natal, South Africa National Renal Care Pty Full time

    Job Title: Dialysis Care SpecialistWe are seeking a highly skilled Dialysis Care Specialist to join our team at National Renal Care Pty in Richards Bay, KwaZulu-Natal.Estimated Salary: R 400,000 - R 600,000 per annum (dependent on experience).About the Role:This is an exciting opportunity for a dedicated professional to work in a fast-paced environment,...