Specialist: Case Manager, Ambulatory PMB at AfroCentric Group

Job Description

To manage the spending of member funds by means of clinical interventions and managed care protocols.

The following will be considered key components for the role:

Client service delivery and quality:

• Follow procedures and cooperate with peers and leader for best possible service delivery

Compliance and Risk Management:

• Identify treatment trends and patterns to manage clinical and financial risk

Financial Management:

• Contribute to cost savings within the department to assist with financial goals and targets

Operational Implementation of Strategy:

• Keep up to date with operational changes implemented in response to important external influences.

Operational Leadership:

• Deliver personal performance within Human Capital frameworks and policies to ensure delivery to agreed standards and objectives

Stakeholder Management:

• Address customer or stakeholder complaints in alignment with the policies and procedures and ensuring customer / stakeholder buy-in

Experience:

• A minimum of 2 years experience as an Enrolled nurse or Registered nurse, knowledge of managed care /retail pharmacy is an advantage

Qualifications:

• Enrolled or Registered Nurse.