Clinical Pre Auth Team Leader

7 months ago


Durban, South Africa MMI Holdings Ltd Full time
Closing Date2023/03/17Reference NumberMMH230118-14Job TitleClinical Pre Auth Team LeaderPosition TypePermanentRole FamilyClient ServicesClusterHealth SolutionsRemote OpportunityNone of the timeLocation - CountrySouth AfricaLocation - ProvinceKwaZulu-NatalLocation - Town / CityCornubia, DurbanIntroduction

Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by using a defined set of Health capabilities.

Role Purpose

The aim of this position is to work together with the Fund, Hospitals and the Service Providers to co-ordinate and monitor a Beneficiary's in and out of hospital health care needs in order to manage quality and costs in line with clinical guidelines and protocols and intervene when appropriate.

Requirements Matric Registered nurse / BPharm with at least a minimum of 3 years' experience  Registration with the professional bodies (SANC/SAPC) At least 3 years demonstrated experience in a Team Leader or leadership role advantageous Previous experience or knowledge of the healthcare industry, financial services, and insurance will an added advantage Knowledge of the Oracle system will be advantageous  Duties & Responsibilities Maintain great staff morale by leading, guiding, developing and supporting team members by identifying appropriate training needs and providing coaching to achieve performance standards Liaise with trainers to ensure that their training material is accurate and continuously updated. Networks with other areas across the business Facilitates and manages projects, system enhancements and changes  Positively influence and participate in change initiatives Continuously develop own expertise in terms of professional, industry and legislation knowledge Communicate the policy and procedures of the company to the team, ensuring that they are implemented. Increase efficiency with tools that enable staff to maintain and monitor cases in terms of quality and cost efficiencies. Supervise staff, including identification of training needs and requirements, granting leave, performance appraisals, and productivity (in terms of quality and quantity) in collaboration with the manager for assisting the manager in the development of the programs and staff. Compiling Health Risk Management (HRM) operational and scheme reports. Attend internal stakeholder and scheme clinical meetings where required Improve customer satisfaction by meeting all customer commitments and service provider requirements. Coaching and supporting the Managed care teams in ensuring a high standard of service delivery. Build and maintain relationships with clients and internal and external stakeholders. Deliver on service level agreements made with clients and internal and external stakeholders in order to ensure that client expectations are managed. Demonstrate exemplary leadership behaviour, through personal involvement, commitment and dedication in support of organizational values.  Execute effective workforce planning practices to ensure that staffing requirements are accurately forecasted. Identify solutions to enhance cost effectiveness and increase operational process efficiency across managed care programmes. Implement and provide input into governance processes, systems and legislation within area of specialization. Provide input into the risk identification processes development and communicate recommendations in the appropriate forum. Competencies Business Acumen Advanced Excel skills Report writing skills Client /Stakeholder Commitment Drive for Result Leads change and innovation Motivating and Inspiring team Self-awareness and insight Diversity and inclusiveness Growing talent Enquiriessiphesihle.zulu@momentum.co.za

  • Durban, KwaZulu-Natal, South Africa Discovery Limited Full time

    Job OverviewThis is an exciting opportunity to join Discovery Limited as a Pre Auth Service Consultant, working in a dynamic environment where you will be responsible for delivering exceptional customer service and ensuring the seamless resolution of queries.


  • Durban, South Africa Discovery Limited Full time

    Job title : Pre Auth Service Consultant - Talent PoolJob Location : KwaZulu-Natal, DurbanDeadline : December 05, 2024Quick Recommended Links Jobs by Location Job by industries Key Purpose To deliver world class service to all Discovery Health Members, Providers, Employer groups, Hospitals, and Brokers by supporting and fully resolving their queries through...


  • Durban, South Africa Discovery Full time

    Discovery Health Pre-authorisations Service Consultant – Talent Pool 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...

  • Clinical Auditor

    7 months ago


    Durban, South Africa Talent Pal Full time

    **Introduction** Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by...


  • Durban, South Africa Discovery Full time

    Discovery Health Pre-authorisation Service Consultant - Vitality Health Servicing - Talent Pool 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...

  • Quality Team Leader

    6 months ago


    Durban, South Africa Tower Group Full time

    TEAM LEADER - QUALITYJOB PURPOSEThe Quality Team Leader is responsible for ensuring the day-to-day quality activities are achieved in all aspects of the Production process. The Quality Team Leader will ensure that the specified quality standards and the inspection frequency of components are met.MINIMUM QUALIFICATIONRelevant Higher Certificate in Quality,...

  • Quality Team Leader

    6 months ago


    Durban, South Africa Tower Group Full time

    TEAM LEADER - QUALITYJOB PURPOSEThe Quality Team Leader is responsible for ensuring the day-to-day quality activities are achieved in all aspects of the Production process. The Quality Team Leader will ensure that the specified quality standards and the inspection frequency of components are met.MINIMUM QUALIFICATIONRelevant Higher Certificate in Quality,...


  • Durban, South Africa HR Ingenuity Full time

    **PURPOSE OF POSITION** Responsible for the facilitation of teaching and learning of the theoretical and clinical component in a clinical environment to reinforce the learning process as well as the integration of theory and practice. **KEY PERFORMANCE AREAS** - The clinical training specialist will undertake activities designed to maximize nursing...


  • Durban, South Africa Netcare Umhlanga Hospital Full time

    The Clinical Nurse Specialist focuses on the delivery of quality competent nursing care. The incumbent acts as a clinical resource and leader in a particular clinical specialty, performing functions at an advanced level competently and consistently. Sound and contemporary knowledge of the area of specialty, together with an advanced understanding of...

  • Quality Team Leader

    6 months ago


    Durban, South Africa TalentCru Full time

    Our client in Automotive Manufacturing is hiring for a Quality Team Leader to oversee day-to-day quality activities in the production process. You will ensure adherence to specified quality standards and inspection frequencies, playing a crucial role in maintaining product integrity.The successful candidates will be required to travel to Thailand for...


  • Durban, South Africa Health Solutions Full time

    **Introduction** - Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by...


  • Durban, South Africa Durpro Workforce Solutions Full time

    The Operational Clinical Nurse Specialist focuses on the delivery of quality competent nursing care. The incumbent acts as a clinical resource and leader in the theatre environment, performing functions at an advanced level competently and consistently. **Key responsibilities**: - Operational management - Advanced clinical care - Consultation as a source...


  • Durban, South Africa Health Solutions Full time

    **Introduction** - Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable,integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation,and create value through unique insights of how to achieve specific outcomes by...


  • Durban, South Africa JOINT MEDICAL HOLDINGS-CITY HOSPITAL Full time

    **JOINT MEDICAL HOLDINGS PROPRIETARY LIMITED** Registration No. 2011/010448/07 **VACANCY: JOINT MEDICAL HOLDINGS** **DIVISION: JMH GROUP** **JOB TITLE: CLINICAL TRAINING SPECIALIST (THEATRE)** **PURPOSE OF POSITION** Responsible for the facilitation of teaching and learning of the theoretical and clinical component in a clinical environment to reinforce...


  • Durban, KwaZulu-Natal, South Africa Unique Personnel Ltd Full time

    Job PurposeTo generate referrals through strong relationships and sound product and service detailing to existing and potential referrers.Key ResponsibilitiesConduct patient assessments for referred patients needing HVP.Conducting product demonstrations and presentations to healthcare providers and end-users.Providing product and technical support and...

  • Team Leader

    7 months ago


    Durban, South Africa Blue Mercury Financial Services Full time

    WE ARE SEEKING TWO TEAM LEADERS TO WORK UNDER EXISTING TEAM LEADERS FOR - DISCOVERY INSURE AND CAPITAL LEGACY. Duties would be running and assisting with the current teams as a 2IC Basic is 8000 rand per month Commision is R18500 **Salary**: R8,000.00 - R9,000.00 per month

  • Team Leader

    4 months ago


    Durban, South Africa Grand Industries Full time

    We are seeking a dedicated and experienced Call Centre Team Leader to join our team. As a Team Leader, you will be responsible for overseeing and managing a team of sales representatives to ensure efficient operation and excellent service delivery. **Responsibilities**: - Supervise a team of sales representatives. - Monitor and evaluate team performance,...


  • Durban, KwaZulu-Natal, South Africa MSP Staffing LTD Full time

    Job OverviewKwaZulu-Natal is seeking an experienced and dedicated nursing professional to lead the Surgical/Intensive Care Unit as a Clinical Lead. This is an esteemed opportunity for a leader with exceptional patient care and efficient unit operations expertise.About the RoleThe successful candidate will be responsible for ensuring exceptional patient care,...

  • Team Leader

    6 months ago


    Durban, South Africa Webhelp Full time

    **Job Advert** If you’re a people's person with a passion for communication, someone who is always willing to go that extra mile to help others an exceed customer’s expectations then this role is written for you! We’re on the lookout for a can-doer who values the importance of team playing to step up as a Team Leader in our vibrant Durban office,...

  • Team Leader

    4 months ago


    Durban, South Africa Smollan Full time

    We are on the lookout for a Team Leader in KZN-Durban As a Team Leader, you will be responsible for: - Sales Management - Shelf Health Management - Control Expenses - Execution of Point of Purchase - Administration - Customer Service and Satisfaction - 2-3 years Operations experience in a Field Marketing structure/sales and merchandising experience in a...