Clinical Authorisation Specialist
1 week ago
The Prospective Reviewer role within the pre-authorisation call centre is a critical position that requires a high level of clinical expertise and analytical skills. As a Prospective Reviewer, you will be responsible for ensuring that hospital authorisation requests meet the requirements of clinical appropriateness, medical necessity, and clinical risk management.
Key Responsibilities:- Authorise hospital authorisation requests by applying coding principles, medical scheme rules, and benefits, as well as managed care policies and processes.
- Capture accurate pre-authorisation data on the system.
- Educate and assist members by providing relevant clinical information to access the correct clinical benefits.
- Consult members' healthcare professionals to make informed clinical decisions and manage financial risk.
- Correctly escalate complex clinical calls.
- Provide excellent customer service.
- Address all customer complaints in alignment with policies and procedures to achieve stakeholder buy-in.
- Formal nursing qualification (SANC enrolled nurse) – required.
- 2 – 3 years' experience in a general medical or general surgical ward, with at least 1 year at a private institution.
- Trauma/ER experience will be an advantage.
- Previous Managed Healthcare experience in a call centre environment – advantageous.
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Clinical Authorisation Specialist
1 week ago
Johannesburg, Gauteng, South Africa Edge Executives Full timeJob Title: Pre-Authorisation ConsultantEdge Executives is seeking a highly skilled Pre-Authorisation Consultant to join our team. As a key member of our healthcare team, you will be responsible for evaluating and approving pre-authorisation requests for hospital admissions, surgeries, and specialised medical treatments.Key Responsibilities:Pre-Authorisation...
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Clinical Authorisation Specialist
4 weeks ago
Johannesburg, Gauteng, South Africa Palesa Mbali Group Full timeJob Title: Prospective ReviewerThe Prospective Reviewer role within the pre-authorisation call centre is a critical position that ensures the efficient processing of hospital authorisation requests. This role requires a strong understanding of clinical appropriateness, medical necessity, and clinical risk management principles.Key Responsibilities:Authorise...
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Clinical Case Manager
5 days ago
Johannesburg, Gauteng, South Africa Edge Executives Full timeJob SummaryWe are seeking a highly skilled Clinical Case Manager to join our team at Edge Executives. As a key member of our healthcare team, you will be responsible for managing hospital admissions, conducting clinical assessments, and coordinating with healthcare providers to ensure the most efficient and cost-effective care is delivered to patients.Key...
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Clinical Case Manager
1 week ago
Johannesburg, Gauteng, South Africa Edge Executives Full timeJob SummaryWe are seeking a highly skilled Clinical Case Manager to join our team at Edge Executives. As a key member of our healthcare operations team, you will be responsible for managing hospital admissions, conducting clinical assessments, and coordinating with healthcare providers to ensure the most efficient and cost-effective care is delivered to...
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Clinical Case Manager
1 day ago
Johannesburg, Gauteng, South Africa Edge Executives Full timeJob SummaryWe are seeking a highly skilled Clinical Case Manager to join our team at Edge Executives. As a key member of our healthcare operations team, you will be responsible for managing hospital admissions, conducting clinical assessments, and coordinating with healthcare providers to ensure the most efficient and cost-effective care is delivered to...
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Clinical Data Specialist
2 weeks ago
Johannesburg, Gauteng, South Africa MECS Africa Full timeJob Title: Clinical Data SpecialistWe are seeking a highly skilled Clinical Data Specialist to join our team at MECS Africa. The successful candidate will be responsible for analyzing patient records, assigning industry-recognised codes, and collaborating with healthcare professionals to ensure information accuracy.Key Responsibilities:Analyzing patient...
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Clinical Sales Specialist
4 weeks ago
Johannesburg, Gauteng, South Africa Boardroom Appointments Full timeClinical Sales Specialist **About the Role** We are seeking a highly motivated and experienced Clinical Sales Specialist to join our team at Boardroom Appointments. As a Clinical Sales Specialist, you will be responsible for driving sales growth and expanding our presence in the cardiovascular and electrophysiology markets. **Key Responsibilities** *...
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Clinical Applications Specialist
3 weeks ago
Johannesburg, Gauteng, South Africa Unique Personnel Ltd Full timeJob Title: Clinical Applications SpecialistUnique Personnel Ltd is seeking a highly skilled Clinical Applications Specialist to join our team. As a key member of our organization, you will be responsible for delivering training programs to healthcare professionals across various hospital locations.Key Responsibilities:Design, deliver, and evaluate training...
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Clinical Sales Specialist
4 weeks ago
Johannesburg, Gauteng, South Africa Boardroom Appointments Full timeClinical Sales Specialist **About the Role** We are seeking a highly skilled Clinical Sales Specialist to join our team at Boardroom Appointments. As a key member of our sales team, you will be responsible for driving sales growth and expanding our presence in the cardiovascular and electrophysiology markets. **Key Responsibilities** * Develop and...
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Clinical Sales Specialist
3 weeks ago
Johannesburg, Gauteng, South Africa Boardroom Appointments Full timeClinical Sales SpecialistWe are seeking a highly motivated and experienced Clinical Sales Specialist to join our team at Boardroom Appointments.Key Responsibilities:Develop and execute sales strategies to drive business growth in the cardiovascular and electrophysiology markets.Build and maintain strong relationships with key stakeholders, including...
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Clinical Care Specialist
16 hours ago
Johannesburg, Gauteng, South Africa Allmed Healthcare Professionals Full time{"title": "Clinical Care Specialist", "content": "Job SummaryWe are seeking a dedicated Clinical Care Specialist to join our Frail Care team in Johannesburg.Location: Sandringham, JohannesburgJob Type: Temp / Agency Shifts (following a 5 day orientation at the facility)Key ResponsibilitiesAccurately document nursing care based on resident observations and...
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Clinical Case Manager
4 weeks ago
Johannesburg, Gauteng, South Africa Ultra Personnel Full timeJob Title: Clinical Case ManagerUltra Personnel is seeking a highly skilled Clinical Case Manager to join our team. As a Clinical Case Manager, you will be responsible for ensuring that healthcare services rendered are accurately accounted for and that patients receive the best possible care.Key Responsibilities:Liaise with Receptionist for authorisations...
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Clinical Case Manager
3 weeks ago
Johannesburg, Gauteng, South Africa Ultra Personnel Full timeJob Title: Clinical Case ManagerUltra Personnel is seeking a highly skilled Clinical Case Manager to join our team. As a Clinical Case Manager, you will be responsible for ensuring that healthcare services rendered are accurately accounted for and that patients receive the best possible care.Key Responsibilities:Liaise with Receptionist for authorisations...
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Clinical Case Manager
4 weeks ago
Johannesburg, Gauteng, South Africa Ultra Personnel Full timeJob Title: Clinical Case ManagerUltra Personnel is seeking a highly skilled Clinical Case Manager to join our team. As a Clinical Case Manager, you will be responsible for ensuring that healthcare services rendered are accurately accounted for and that patients receive the best possible care.Key Responsibilities:Liaise with Receptionist for authorisations...
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Clinical Training Coordinator
2 weeks ago
Johannesburg, Gauteng, South Africa Wits University Full timeJob Title: Clinical Training CoordinatorWits University is seeking a highly skilled and experienced Clinical Training Coordinator to join our team. The successful candidate will be responsible for coordinating the clinical training of medical students in the final two years of the MBBCh degree, including the general management of clinical rotations and...
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Clinical Support Specialist
2 weeks ago
Johannesburg, Gauteng, South Africa Kaelo Full timeClinical Consultant Job DescriptionThe Clinical Consultant is a highly skilled professional responsible for delivering clinical support and counselling services to clients. This role requires a deep understanding of clinical practices and the ability to establish effective treatment plans.Key Responsibilities:Provide high-quality telephonic counselling...
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Clinical Training Coordinator
16 hours ago
Johannesburg, Gauteng, South Africa Wits University Full timeJob Title: Clinical Training CoordinatorWits University is seeking a highly skilled and experienced Clinical Training Coordinator to join our team.Key Responsibilities:Coordinate the clinical training of medical students in the final two years of the MBBCh degree, including the general management of clinical rotations and integrating processes.Coordinate...
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Clinical Training Coordinator
4 weeks ago
Johannesburg, Gauteng, South Africa Wits University Full timeJob Title: Clinical Training CoordinatorWits University is seeking a highly skilled and experienced Clinical Training Coordinator to join our team.Key Responsibilities:Coordinate the clinical training of medical students in the final two years of the MBBCh degree, including the general management of clinical rotations and integrating processes.Coordinate...
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Mako Product Specialist
1 month ago
Johannesburg, Gauteng, South Africa Stryker South Africa (Pty) Ltd. Full timeAbout the Role:Stryker South Africa (Pty) Ltd. is seeking a highly skilled Mako Product Specialist to provide clinical product support to end-users of our pioneering MAKO Robotic Surgery Products in Gauteng, South Africa.Key Responsibilities:Provide on-site guidance and assistance during surgical procedures to ensure optimal product performance and user...
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Clinical Care Specialist
2 weeks ago
Johannesburg, Gauteng, South Africa Allmed Healthcare Professionals Full timeJob Title: Enrolled Nurse - Frail CareWe are seeking dedicated Enrolled Nurses to join our Frail Care team in Johannesburg.Location: Sandringham, JohannesburgJob Type: Temp / Agency Shifts (following a 5-day orientation at the facility)Role and Responsibilities:Clinical CareAccurate nursing documentation based on observation & daily assessment of the...