Clinical Authorization Specialist
1 month ago
Palesa Mbali Group
We are seeking a highly skilled Clinical Authorization Specialist to join our Pre-Authorization Call Centre team.
Key Responsibilities:
- Authorizing hospital authorization requests by applying coding principles, medical scheme rules and benefits, and managed care policies and processes.
- Capture accurate pre-authorisation data on the system.
- Educate and assist members by providing relevant clinical information to access correct clinical benefits.
- Consult member's 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.
Requirements:
- 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.
- Minimum of 3 years in the clinical space required.
- Must be computer literate.
- Call centre experience advantageous.
- Previous Managed Healthcare experience in a call centre environment – advantageous.
Compensation: The estimated salary for this position is R250,000 - R300,000 per annum, depending on experience.
-
Clinical Authorization Specialist
1 month ago
Cape Town, Western Cape, South Africa Palesa Mbali Group Full timeJob SummaryWe are seeking a skilled Clinical Authorization Specialist to join our team at the Palesa Mbali Group. This is an exciting opportunity for a qualified professional to utilize their expertise in clinical authorization and customer service to make a meaningful impact.About the RoleThe Clinical Authorization Specialist will be responsible for...
-
Medical Authorization Specialist
2 months ago
Cape Town, Western Cape, South Africa Palesa Mbali Group Full timeJob SummaryThe Palesa Mbali Group seeks a Medical Authorization Specialist to join their team in the pre-authorization call centre. This role involves authorizing hospital authorization requests, ensuring that requirements of clinical appropriateness, medical necessity and clinical risk management are met.Main ResponsibilitiesApply coding principles, medical...
-
Clinical Nursing Specialist
4 weeks ago
Cape Town, Western Cape, South Africa Jordan HR Full timeJob Title: Clinical Nursing SpecialistWe are seeking a highly skilled Clinical Nursing Specialist to join our team at Jordan HR.About the Role:This is an exciting opportunity for an experienced nurse to take on a leadership role and contribute to the delivery of high-quality patient care. The successful candidate will have excellent clinical skills, strong...
-
Nursing Clinical Specialist
3 weeks ago
Cape Town, Western Cape, South Africa TRANSGENERATIONAL Full timeNursing Clinical SpecialistJob Summary:We are seeking an experienced Nursing Clinical Specialist to join our team at Transgenerational. The successful candidate will be responsible for facilitating teaching and learning in a clinical setting, ensuring high-quality patient care and promoting staff development.About the Role:Reports directly to the Nursing...
-
Clinical Research Quality Assurance Specialist
3 weeks ago
Cape Town, Western Cape, South Africa University of Cape Town Lung Institute Full timeJob DescriptionThe University of Cape Town Lung Institute is seeking a highly skilled Clinical Research Quality Assurance Specialist to join their team. The ideal candidate will have 3-5 years of experience in clinical research and a strong understanding of quality management principles.This role involves ensuring regulatory compliance and quality control...
-
Clinical Trial Quality Assurance Specialist
3 weeks ago
Cape Town, Western Cape, South Africa University of Cape Town Lung Institute Full timeJob DescriptionWe are seeking a highly skilled Clinical Trial Quality Assurance Specialist to join our team at the University of Cape Town Lung Institute. As a key member of our research staff, you will play a crucial role in ensuring the quality and integrity of our clinical trials data.ResponsibilitiesDevelop and implement quality assurance procedures for...
-
Clinical Research Administration Officer
3 weeks ago
Cape Town, Western Cape, South Africa University of Cape Town Lung Institute Full timeJob Title: Clinical Research Administration OfficerWe are looking for a highly organized and detail-oriented Clinical Research Administration Officer to join our team at the University of Cape Town Lung Institute.Job Summary:The successful candidate will be responsible for ensuring the smooth administration of clinical research studies, including submission...
-
Regulatory and Ethics Compliance Specialist
3 weeks ago
Cape Town, Western Cape, South Africa University of Cape Town Lung Institute Full timeJob Title: Regulatory and Ethics Compliance SpecialistWe are seeking a highly skilled Regulatory and Ethics Compliance Specialist to join our team at the University of Cape Town Lung Institute.Job Summary:The successful candidate will be responsible for ensuring compliance with regulatory and ethics requirements in clinical research, including submission of...
-
Cape Town, Western Cape, South Africa MSP Staffing LTD Full timeMSP Staffing LTD is seeking a highly skilled Clinical Nurse Specialist to join their team in Cape Town. This is an exceptional opportunity for an experienced ICU nurse to take on a leadership role and contribute to the growth and development of the organization.Job Summary:The Clinical Nurse Specialist will be responsible for providing high-quality patient...
-
Respiratory Clinical Specialist
3 weeks ago
Cape Town, Western Cape, South Africa University of Cape Town Lung Institute Full timeJob Overview:The University of Cape Town Lung Institute is seeking a skilled clinical research coordinator to support our team's efforts in lung function testing and patient care. As a member of our team, you will have the opportunity to contribute to groundbreaking research and work closely with experienced professionals in the field.Job Responsibilities:-...
-
Clinical Operations Specialist
4 weeks ago
Cape Town, Western Cape, South Africa Jordan HR Full timeJob OverviewWe are seeking a highly skilled Clinical Facilitator to join our team at Jordan HR.Salary InformationThe estimated salary for this position is R1,200,000 - R1,500,000 per annum, depending on experience.Job DescriptionA key member of our healthcare team, the successful candidate will be responsible for facilitating clinical operations and...
-
Paeds Clinical Nurse Specialist
3 weeks ago
Cape Town, Western Cape, South Africa Mednurse Full timeAbout MednurseMednurse is a leading healthcare provider dedicated to delivering exceptional patient care.Salary and BenefitsWe offer a competitive salary of approximately $70,000 per annum, depending on experience, as well as a comprehensive benefits package.Job DescriptionAs a Paeds Clinical Nurse Specialist, you will be responsible for providing...
-
Clinical Healthcare Specialist
3 weeks ago
Cape Town, Western Cape, South Africa Premium Consulting Full timeCompany Overview:Premium Consulting is a renowned healthcare consulting firm dedicated to providing exceptional services to clients across the globe.Salary: R250,000 - R350,000 per annumJob Description:We are seeking an experienced Clinical Nurse Practitioner to join our team in delivering high-quality patient care and support.Required Skills and...
-
Clinical Facilitator Specialist
3 weeks ago
Cape Town, Western Cape, South Africa Jordan HR Full timeJob Title: Clinical FacilitatorWe are seeking a skilled Clinical Facilitator to join our team at Jordan HR, a Private Hospital Group based in the Southern Suburbs of Cape Town.About the Role:Assess staff competence according to company standards and develop strategies for improvement.Plan, prepare, implement, and manage education and training requirements to...
-
Clinical Coordination Specialist
3 weeks ago
Cape Town, Western Cape, South Africa Pillango Placements Full timePillango Placements is seeking an experienced Clinical Coordination Specialist to join our team.Job DescriptionThe successful candidate will be responsible for coordinating bone marrow and peripheral blood stem cell donations, ensuring donor preparation, informed consent, and medical eligibility evaluation. This includes managing donor medical assessments,...
-
Lead Hospital Unit Manager
1 month ago
Cape Town, Western Cape, South Africa Mednurse Full time**Job Summary:**We are seeking an experienced and dedicated Lead Hospital Unit Manager to join our team at Mednurse. As a key member of our leadership team, you will be responsible for overseeing the delivery of safe, high-quality patient care in a structured hospital environment.The successful candidate will have a strong clinical background, excellent...
-
Research Nurse Specialist
3 weeks ago
Cape Town, Western Cape, South Africa University of Cape Town Lung Institute Full timeJob Title: Research Nurse SpecialistAbout the Job:We are seeking a highly skilled and experienced Research Nurse Specialist to join our team at the University of Cape Town Lung Institute. As a Research Nurse Specialist, you will play a critical role in coordinating research projects, conducting clinical duties, collecting data, and assisting with logistical...
-
Healthcare Specialist
4 weeks ago
Cape Town, Western Cape, South Africa Mobi Train Full timeJob Title: Healthcare SpecialistMobi Train is seeking a skilled and dedicated Healthcare Specialist to join our team. The ideal candidate will possess strong clinical skills and the ability to work effectively with patients, families, and healthcare teams.Estimated Salary: R 150,000 - R 200,000 per annumJob Description:As a Healthcare Specialist at Mobi...
-
Medical Research Specialist
3 weeks ago
Cape Town, Western Cape, South Africa University of Cape Town Lung Institute Full time**About the Job:**We are seeking a highly skilled Medical Research Specialist to join our team at the University of Cape Town Lung Institute. The successful candidate will be responsible for coordinating clinical studies, ensuring the highest quality data collection and analysis.The ideal candidate will have a certificate or degree in Clinical Technology or...
-
Medical Support Specialist
5 days ago
Cape Town, Western Cape, South Africa AVI Limited Full timeAn exciting opportunity has arisen for a Medical Support Specialist at AVI Limited, Cape Town Waterfront.Job OverviewWe are seeking a skilled and dedicated Medical Support Specialist to join our team. As a Medical Support Specialist, you will play a critical role in providing high-quality medical support to our employees.Key Responsibilities:Nursing Care of...