Case Manager

1 week ago

Durban, KwaZulu-Natal, South Africa AfroCentric Group Full time R104 000 - R240 000 per year

Purpose

Deliver and enable excellence in all service moments to all stakeholders (Members, Providers, Employer groups, Intermediaries, Schemes). Personalised clinical servicing through the Omni channel experience focusing on the overall care quality of interaction between our customers and the brand. Providing holistic care that is personalised and accessible, managing the care journey end to end.

Experience:

Managed Healthcare Operations experience 2 years Advantageous

Clinical experience 3 years Essential

Qualifications

Bachelors Degree (3 years) / NQF level 7(Registered Nursing Qualification, plus registration with SA Nursing Council)

Diploma / NQF level 6(Registered Nursing Qualification, plus registration with SA Nursing Council)

4 year Degree / NQF level 7 Allied Healthcare professional. Relevant and active registration with regulatory body

Position Specific KPA

Manage Care Service Requests

Servicing all key stakeholders in the moment across all servicing channels as required until the clinical service request has been resolved.

Educating stakeholders on self-help digital servicing tools. Connecting with your customers (all stakeholders) across all channels, enabling an intuitive experience bringing across our brand authentically. Providing a seamless, progressive and holistic approach, understanding the customer's needs.

Manage authorizations

Manage and or validate the customer's authorizations needs with care, understanding and empathy. Caring holistically for the patient journey.

Manage Cases

Manage clinical cases enabling a holistic personalised intervention. Caring holistically for the patient and their support structure journeys.

Manage Excellent Experiences

Provide accurate and consistent information, meeting all quality standards and measures.

Deliver excellence in customer satisfaction.

Strive to identify areas of improvement and sharing of ideas with your team.

Collaborate with all teams to enable peer to peer learning

Drive Brand Loyalty

Being a brand ambassador, allowing the brand presence to be felt as an extension of the experience.

Knowledge

Advanced Health Care Industry

Advanced Good understanding of the Health Care Environment and Facilities

Advanced Health legislation and regulatory

Basic Application of service processes

Advanced Customer service

Advanced Customer preferences and personality styles

Technical

Basic Microsoft Suite

Basic use of technology

Basic channel experience

Turnaround Time

The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of line managers.

Our Commitment to Transformation

AfroCentric is committed to transformation and embracing diversity. Our Employment Equity plan and targets will be considered as part of the recruitment process. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce, representative of the demographics of our society as well as people with disabilities.

Should you not hear from us within a month of applying, consider your application unsuccessful
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