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Specialist Case Manager
2 weeks ago
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 Operational 2 years Advantageous
Specialised Clinical experience. (e,g, ICU, Neonatal, Renal, Psch, etc) Operational 2 - 3 years Essential
Qualifications
Bachelors Degree (3 years) / NQF level 7(Registered Nursing Qualification, plus registration with SA Nursing Council) Advantageous
Diploma / NQF level 6(Registered Nursing Qualification, plus registration with SA Nursing Council)
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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