Case Manager

5 months ago

Pretoria, South Africa Medical Protection Society Full time

Job Introduction
The Member Cases and Claims Division is at the forefront of protecting the careers, reputation and financial risk of our members worldwide. The purpose of the role is to support the provision of excellent case handling services for members which is trusted and valued and provides fair treatment and outcomes. The role will do this by managing a case load of files and using expert knowledge and judgement to formulate strategies in order to advise and guide members on relevant processes, ensuring an excellent member service is provided

Main Responsibilities
Responsibilities will include but not limited to the following

**Service Delivery**

Deliver the performance of assigned case files in accordance with governance, policy and process ensuring quality and fair outcomes for the member and the membership fund
Proactively manage assigned case files and work effectively to deliver within agreed SLAs ensuring maximum efficiency is achieved whilst providing an excellent service to the member.

Escalate as required any technical matters and/or for advice using such opportunities to build confidence and competence in role

Support Case Handling projects/initiatives ensuring delivery of projects to time, cost and quality and that can demonstrate a return on investment

**Financial**

Manage all spend incurred serving members in accordance with MPS organisation governance and policy

Minimise case costs through proactively managing estimates, challenging costs and invoices from all third party

Determine the level of member assistance to be granted in accordance with the membership policy and benefits on individual cases; escalate cases where out of policy discretion requires consideration.

**Member**

Manage informal complaints / expressions of dissatisfaction to achieve first touch resolution for our members and in accordance with policy standards and process ensuring fair outcomes for members, the membership fund

Seek opportunities to continuously improve ways of working and contribute to team, department and divisional continuous improvement projects aimed to drive operational efficiency and great member experiences and outcomes

Deliver at all times fair treatment and outcomes for members and compliance with associated policies and standards set out by Council, its committees and delegated authorities

Using the most appropriate channel of communications, keep members regularly informed ensuring the advice and support reflects policy, relevant codes of practice, is technically accurate and with outcomes delivered in a professional and empathetic manner

**Essential**
- Educated to degree level or equivalent experience in similar field / role

**Desirable**
- Post-graduate level or equivalent experience
- Knowledge of medical/dental law and ethics, and regulatory environment, policies and procedures
- Legal or medical /dental qualification

**Essential Experience**
- Customer service / member management
- Management of claims / cases of varying complexity
- Experience in healthcare or legal background

**Desirable Experience**
- Experience of training, coaching or mentoring
- Regulatory / Inquests /Criminal Case management
- Working with medics / dentists or other professional bodies

About The Company
Medical Protection Society (MPS) is the world’s leading protection organisation for doctors, dentists and healthcare professionals. We protect and support the professional interests of more than 300,000 members around the world, in countries as diverse as the United Kingdom, South Africa and Hong Kong. We strive to be much more than a last line of defence by being at our members’ side at every step, offering support, advice and world-class defence. Membership provides access to expert advice and support together with the right to request indemnity for complaints or claims arising from professional practice. We continue to invest in our team to ensure that we are delivering the best possible service for members. This was recognised in 2016 when we were awarded an Investors in People Silver award.

Package Description
Benefits will include;
- Bonus (up to 15%)
- Pension
- Medical Aid
- Group Life Cover

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