Clinical Specialist

Discovery Health - Strategic Risk Management

Clinical Specialist (Doctor)

About Discovery

Discovery's core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders, Discovery is passionate about innovating in order to not only achieve financial success, but to ignite positive and meaningful change within our society.

About Strategic Risk Management

Strategic Risk Management (SRM) is a business-critical department in Discovery Health, holding the responsibility for ensuring sustainable and equitable management of scheme funds to deliver patient care. It houses multiple teams of experts in clinical, actuarial, and managerial roles all striving to gain the highest value for members who need care. SRM is a fast paced, highly visible and complex area of healthcare management with opportunities for executive visibility, external client engagement and innovation.

About Healthcare Delivery Transformation

The Healthcare Delivery Transformation (HDT) unit designs and implements innovative strategies, technologies, processes and delivery models to streamline patient care, optimise resource utilisation, enhance patient outcomes and reduce costs. Key functions include analysing data to identify areas for improvement, designing and implementing new care delivery models, fostering collaboration among healthcare stakeholders (i.e. healthcare providers, technology vendors and policy makers), and continuously evaluating and adjusting strategies to optimize outcomes and drive systemic changes and improve the overall healthcare delivery ecosystem. Their work includes Care at Home initiatives (i.e. Hospital at Home, Virtual Chronic Care, Virtual Urgent Care and Virtual Physical Therapy), Care model shared value initiatives (i.e. Coronary Artery Disease VBC, Arthroplasty VBC, Ambulatory and Short Stay Surgical Care, Endoscopy VBC, Cataracts VBC).

Key Purpose

Developing a vision, design (model, benefits, partners, build including operational delivery and systems), delivery roadmap, monitoring and scaling of selected healthcare delivery, Value-Based Care (VBC) and digital transformation initiatives aligned to the SRM and wider organisational strategy. Engagement with health providers, senior industry bodies and thought leaders regarding care delivery transformation. Has the authority, accountability, and responsibility to manage specific healthcare delivery transformation initiatives to achieve specific objectives.

Areas of responsibility may include but not limited to

- Monitor, with the support of the wider SRM team, key metrics reflecting healthcare spend and utilization experience and recommend risk mitigation strategies to curb wasteful healthcare spend and enhance efficiencies.
- Proactively identify and develop creative, large, and complex care delivery shared value initiatives and drive implementation roadmap, monitoring, and scaling of these initiatives.
- Develop frameworks and mechanisms to track the ongoing effectiveness of initiatives and ensure they continue to deliver on intended objectives.
- Co-ordinate and conduct activities with the main internal stakeholders in order to create the relevant documentation for external engagement.
- Provide a professional, disciplined, industry referenced and forward-thinking approach to evaluating and improving the effectiveness of clinical pathways.
- Where necessary, engage with providers and senior industry bodies to obtain opinion on clinical trends identified, clinical pathways, and influence wider adoption of care delivery shared value initiatives.
- Actively contribute to the efficient and effective functioning of the Healthcare Delivery Transformation unit and SRM
- Work closely with Discovery Health servicing, operations, digital and systems teams to ensure the highest levels of responsiveness.

Competencies

- Works strategically to realise organisational goals. Sets and develops strategies. Identifies and develops positive and compelling visions of the organisation's future potential. Takes account of a wide range of issues across, and related to, the organisation.
- Sets clearly defined objectives. Plans activities and projects well in advance and takes account of possible changing circumstances. Manages time effectively. Identifies and organises resources needed to accomplish tasks. Monitors performance against deadlines and milestones.
- Ability to make prompt, clear decisions, which may involve tough choices or considered risks. Takes responsibility for actions, projects and people. Takes initiative and acts with confidence working under own direction. Initiates and generates activity.
- Focuses on customer needs and satisfaction. Sets high standards for quality and quantity. Monitors and maintains quality and productivity. Works in a systematic, methodical and orderly way. Consistently achieves project goals.
- Establishes good relationships with customers and staff. Builds wide and effective networks of contacts inside and outside the organisation. Relates well to people at all levels.
- Makes a strong personal impression on others. Gains clear agreement and commitment from others by persuading, convincing and negotiating. Promotes ideas on behalf of self or others. Manages conflict.
- Analyses numerical data, verbal data and all other sources of information. Breaks information into component parts, patterns and relationships. Probes for further information or greater understanding of a problem. Makes rational judgements from the available information and analysis. Produces workable solutions to a range of problems. Demonstrates an understanding of how one issue may be a part of a much larger system.
- Rapidly learns new tasks and quickly commits information to memory. Gathers comprehensive information to support decision making. Demonstrates a rapid understanding of newly presented information. Encourages an organisational learning approach (i.e. learns from successes and failures and seeks staff and customer feedback). Manages knowledge (collects, classifies, and disseminates knowledge of use to the organisation).

Education and Experience

- A qualified Medical Doctor (registered with the HPCSA), with strong analytical or business focus
- 3 – 5 years of managed care funding or commercial organisation experience would be preferred
- Ability to work with analytical teams in the development of Healthcare Delivery Transformation initiatives
- Significant experience in the healthcare industry and understanding of the key business and clinical issues with a proven track record of innovation, delivery and performance
- Public forum experience is critical
- Excellent interpersonal and presentation skills
- Strong administrative skills (MS Excel, MS Word & Power Point are essential)

Advantageous/Preferred Experience and Knowledge:

- Master's degree in Business Administration, Healthcare Management, Health Economics or Administration or other
- At least 5 years' experience leading successful implementation of business initiatives or strategy

EMPLOYMENT EQUITY

The Company's approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.

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