Specialised Healthcare Coach

1 week ago

Bellville, South Africa Momentum Health Full time

**Introduction**- Through our client-facing brands Momentum Group, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. We help people grow their savings, protect what matters to them and invest for the future. We help companies and organisations care for and reward their employees and members.

**Disclaimer**- As an applicant, please verify the legitimacy of this job advert on our company career page.

**Role Purpose**- To manage clinical risk of patients through the authorisation of clinically appropriate treatment and outbound interventions.

**Requirements**- Matric
- Nursing Diploma / Nursing Degree / Certificate in Nursing is essential
- Minimum of 4 years clinical experience essential
- Registered with SANC essential
- Experience in managed health care would be advantageous-
- **Duties & Responsibilities**- Liaising with patients, providers and Disease Management companies
- Answering and assisting with all queries related to disease management programmes
- Following up on decisions with Providers and/or 3rd parties
- Maintaining relationships with 3rd parties
- Monitoring the progress of patience on disease management programmes.
- Assisting with early detection programmes and advocating available preventative health benefits to better manage risk
- Facilitating reports to the scheme
- Initiating outbound contact with patients and providers where appropriate
- Educating and guiding all members regarding health care and their benefits
- Authorising appropriate and cost effective medical care and treatment
- Possible identification of clinical guidelines.
- Identifying all compliance risks.
- Supporting budget control and cost containment of health management programmes.
- Assisting with registration on various programmes to ensure quality of life for patients with life threatening diseases
- Dealing promptly with client requests in a competent, efficient and professional manner.
- Liaising with specialists to gain their insight into assessing risks.-
- **Competencies**- Accountability
- Planning
- Organization and Attention to Detail
- Customer orientation
- Empathy
- People skills
- Teamwork and Cooperation
- Business Administration
- Results Orientation

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