HRm Clinical Specialist: Chronic

1 month ago

Durban, South Africa Health Solutions Full time

**Introduction**

Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation and create value through unique insights of how to achieve specific outcomes by using a defined set of Health capabilities.

**Role Purpose**

Responsible for ensuring improved operational excellence employee performance, provision of onboarding HRM plans, ongoing monitoring, inspection and mentoring. Application of effective, appropriate clinical protocols and guidelines throughout the Chronic Management Programme. Ensuring effective drug utilisation monitoring and review for adequate health outcomes and cost-containment.

**Requirements**:

- Matric
- Bachelor of Pharmacy Degree
- Valid SAPC (South African Pharmacy Council) registration
- Minimum 3 years' experience in a managed healthcare environment with experience of Drug Utilisation Review.
- Previous experience on projects, quality trends analysis and management
- Previous chronic management experience would be an advantage
- Strong knowledge of PMB legislation, Clinical Coding (NAPPI, ICD 10, CPT & NHRPL), Formularies, hospital and doctor’s billing guidelines is highly advantageous

**Duties & Responsibilities**
- Conducting drug utilisation reviews (DUR) in an effective and professional manner
- Maintaining acceptable productivity levels in the running of the programme
- Reviewing, updating clinical protocols and guidelines
- Ensuring effective communication between all stakeholders
- Providing clinical expertise within the organisation where required
- Ensuring overall provision of a cost-effective and competitive Chronic Medicine programme
- Providing clinical support and guidance for disease management programmes
- Assisting in the conceptualisation, planning and implementation of new managed care products and projects
- Perform quality assurance of work performed by the MRM, DRM and Wellness team. Provide feedback and recommendations
- Monitor quality and provide training, mentoring, assistance and motivation to the MRM DRM and Wellness teams to ensure department service objectives are met
- Maintain system files on each patient enrolled, intervene in accordance with prescribed clinical guidelines and provide periodic outcomes reports on all cases
- To assist in the drafting and distributing of info-brochures to enrolled patients and providers
- Collaborate with and provide information (based on a professional knowledge of medicines) to other departments within the organisation to achieve focus on preventative healthcare and total risk management
- To monitor the provision of healthcare services to patients registered for Disease Risk Management

**Competencies**
- Understands how the business operates, what the key issues and risks are that drives business success; and how they impact on the commercial viability of potential ventures and the profitability of the Group
- Creates and maintains an open, positive working environment by generating commitment, building trust, a shared sense of purpose, empowerment in others and encouraging them to contribute to the best of their ability.
- Prioritises the business interests of MHS and invests in the success of the group by aligning effort across divisions.
- Persuades, convinces, influences, and inspires others, both within MHS and externally to win support, loyalty, and gain commitment to the purpose of MHS.
- Manages self and relationships with others effectively, deals with ambiguity, uncertainty, and pressure, and provides perspective in difficult situations.
- Is sensitive to individual and cultural differences and demonstrates humility and an openness to engage people from diverse backgrounds and cultures to the mutual benefit of all parties concerned.
- Takes responsibility for own development. Good communication, planning and prioritising abilities
- Excellent MS Office proficiency

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