Clinical Policy Developer TALENT POOL

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.

To apply evidence-based medicine principles to develop, update, and maintain clinical tools, policies, and guidelines, whilst providing expert clinical support and resolving document-related queries.

PROCESS

• Conduct in-depth research, involve stakeholders, and utilise new technology to create evidence-based policies and disease management treatment plans.
• Regularly review and update existing policies, maintaining relationships with stakeholders and external consultants.
• Maintain a comprehensive central repository of health technology assessments and related materials.
• Actively participate in and contribute to continuous improvement initiatives within the organisation, exploring new methodologies and technologies to enhance the efficiency and effectiveness of policy development processes.
• Monitor changes in legislation and update policies accordingly to maintain compliance.
• Analyse healthcare data and feedback to make data-driven decisions, refining existing policies and developing new ones as needed.
• Maintain meticulous documentation of policy development processes, revisions, and updates.
• Implement a robust version control system to track changes, ensuring that all stakeholders have access to the latest versions of policies and guidelines.

CLIENT

• Monitor and enhance turnaround times and quality standards, resolving issues promptly to ensure superior client service.
• Manage client queries efficiently, tracking resolutions and utilising feedback for process improvement.
• Provide expert advice to clients, maintain relationships, negotiate service level agreements, and deliver on commitments to manage client expectations effectively.

PEOPLE

• Foster positive relationships, provide specialist guidance, and actively contribute to continuous innovation and development.
• Embrace change, support colleagues, and drive career development initiatives.
• Cultivate a work-centric culture that emphasises productivity, service excellence, and quality management.
• Collaborate with cross-functional teams, including medical professionals, researchers, and administrators, to gather diverse perspectives and insights.
• Foster effective teamwork and communication to ensure well-rounded and comprehensive policy development.
• Develop training programs and resources for internal staff to enhance their understanding of clinical policies and procedures.
• Conduct workshops and training sessions to ensure that employees across different departments are well-informed and compliant with the established policies.

FINANCE 

• Contribute to budget development, minimising expenditure while aligning with operational plans.
• Identify cost-effective solutions, enhance operational efficiency, and comply with governance processes and legislation.
• Escalate policy and compliance issues, provide input into risk identification, and communicate recommendations for resolution.

• Post graduate diploma or equivalent qualification in Health Technology Assessment is desirable.
• Bachelor of Nursing (BN) degree or a Diploma in Nursing (General, Midwife, Psychiatric Nurse and Community Health) and or relevant equivalent qualification is essential.
• Basic ICD10 coding course is essential.
• Registration as a Professional Nurse with the South African Nursing Council (SANC).
• 3 - 5 years experience in clinical development industry or a related field
• Clinical coding systems, including Current Procedural Terminology(CPT), International Classification of Diseases, 10th Edition (ICD-10), and Relative Value Scale Update Committee (RPL) coding standards.
• Demonstrated working knowledge of essential software tools, including MS Word, Access, SharePoint, and PowerPoint
• Advanced proficiency in Excel, including complex data analysis, formulae, and functions
• Familiarity with data analysis and clinical reporting methodologies
• Knowledge of the entire clinical policy development lifecycle, including the application of evidence-based medicine principles, regulatory compliance, and industry best practices, data analysis, and template systematisation
• Understanding of healthcare protocols, guidelines, and procedures

• Research skills
• Business writing skills
• Reporting skills
• Relationship building skills
• Negotiation skills
• Communication skills (written and verbal)