Clinical Care Specialist at Discovery Limited

Key Purpose:

• To holistically review the needs of clinically complex members and coordinate their care in the most appropriate setting, liaising with internal and external stakeholders to ensure the best clinical outcomes.

Key Outputs

• Perform health assessments on patients in order to identify individual patient risk factors
• Perform interventions to influence individual patient risk
• Promote behavior change to ensure greater treatment compliance and condition management
• Authorising of admissions and treatment as per agreed protocols
• Assist members with clinical related queries
• Proactively assist complex member with understanding their plan benefits and maximizing their use to effect risk savings in the long term
• Monitor patient progress through ongoing patient interaction and follow-up.
• Co-ordination of integration of care including social services where appropriate.
• Maintain relationships between key internal and external stakeholders
• Refer to other departments where appropriate to ensure that the relevant benefits are provided

 Education and Experience:

The following requirements are essential:

• Matric
• Registered Nurse qualification
• Valid SANC registration
• MS Office
• At least 3 years clinical nursing experience, post training.

The following requirements will be advantageous:

• Managed care experience
• Discovery Health system knowledge and experience