Healthcare Navigator

4 weeks ago


Durban, KwaZulu-Natal, South Africa MMI Holdings Ltd Full time
About MMI Holdings Ltd

Momentum Health Solutions, a division of MMI Holdings Ltd, provides comprehensive health solutions that cater to diverse client segments and maximize lifetime value.

Job Description

We are seeking a skilled Wellness Coach to join our team. As a key member, you will be responsible for managing the quality and cost of clinical care by collaborating with members and providers. Your primary goal will be to prevent complications and high-cost admissions while providing holistic guidance and support to high-risk members.

Responsibilities
  1. Ensure alignment with the Wellness department's needs and role profile.
  2. Prioritize work based on required patient management intensity.
  3. Plan and organize daily tasks in accordance with allocated members.
  4. Account for daily workload and required interventions.
  5. Interact with patients, GPs, specialists, and other providers, including home-based and convalescent nurses.
  6. Manage the quality and cost of clinical and medical care by liaising with members and providers.
  7. Work with individual consumers to achieve better health outcomes.
  8. Reduce downstream clinical and financial risk associated with beneficiaries.
  9. Coordinate interactions between various providers and hospitalists.
  10. Maintain detailed records of patient interactions and follow-ups.
  11. Ensure accurate and timely completion of relevant documentation.
Requirements
  • Matric certification.
  • Registered Nurse with a degree or diploma (General, Psychiatric, Midwifery, and Community).
  • Current registration with SANC.
  • Training as a Primary Care Nurse Practitioner is advantageous.
  • Minimum three years of clinical practice experience.
  • Experience in Health Risk Management, Case Management, and Disease Risk Management is beneficial.
  • Strong knowledge of PMB legislation, Clinical Coding (ICD 10, CPT & NHRPL), hospital, and doctor's billing guidelines.
Salary Range

R450,000 - R550,000 per annum, depending on experience and qualifications.



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