Head of HealthCare Operations (Parktown) at Rand Mutual - RMA

Description
THE JOB AT A GLANCE

• As the Head of HealthCare, you will be reporting to the CEO of COID & Group Operations.You will be responsible for providing strategic direction and evaluation of the sub-acute rehabilitation centre and fostering sustainable interdisciplinary collaboration towards achieving the goal of successful and cost-effective rehabilitation for customers.  You will also be responsible for execution of our RMA HealthCare Strategy, ensuring that all the revenue budget and occupational rate for the sub-acute rehab centre is managed appropriately and achieved.

WHAT WILL YOU DO?

• Implementation of the HealthCare Strategy
• Provide strategic and creative direction of the HealthCare strategy
• Execution of the HealthCare Strategy and monitor deliverables
• Build a Sub-Acute Rehab centre that is fit for to compete in the market and ensuring compliance with legislation and that it is consistent with the overall RMA strategy
• Adjudicate requests for additional care and confer with senior RMA medical personnel prior to decision making
• Explore the model of the centre and mobile clinics for better quality care.
• Managing the Sub Acute Rehab Centre
• Oversee all activities of the rehabilitation centre
• Develop an operating model for the sub-acute rehab centre
• Support or assist the Rehabilitation team to execute the rehabilitation and early return to work framework
• Assist in the enhancement of the mapped process for the medical management and rehabilitation team
• Provide strategic and operational input to the day-to-day activities of the Rehabilitation centre
• Provide clinical leadership to ensure personalised, safe, effective, and timely quality patient care for patients of the specialty at the RMA subacute rehabilitation facility
• Ensure legislative and RMA policy compliance in all rehabilitation practices
• Oversee the internal policies, processes and procedure on the coordinated case management at the sub-acute rehab centre
• Work with the rehabilitation team to identify and establish potential provider networks that will support the centre
• Ensure cost effective patient assessment and treatment plans
• Adhere to the service level agreements or turnaround times to enhance the overall claim management processing cycle.
• Customer and Stakeholder Relations
• Develop promotional campaigns for the centre, working with the social insurance team
• Ensure customer satisfaction pertaining to sub acute rehabilitation centre services
• Engage with hospital management and provider networks to establish strong stakeholder relationships
• Work collaboratively with managers in Medical, Claims Management, and internal and external MSPs to promote RMA Benefits and negotiate improved tariffs
• Engage with internal and external stakeholders to investigate and identify operational needs and areas of improvement in line with the company strategy
• Effectively collaborate with respective business units to implement customer centric business processes and technology solutions
• Document and implement operational needs to solve business challenges and help drive customer service delivery
• Support the COID and Group Operations management team in identifying, assessing and providing solutions to business requirements
• Liaise with relevant stakeholders to identify, assess, and document business requirements.
• Reporting
• Provide feedback to COID and Group Operations Management on occupancy rate, progress of the sub acute rehab centre operating model in line with the targets, hospital medical spend and provider usage patterns
• Monthly reporting on sub acute rehabilitation centre revenue and expenses status and progress.
• Team Leadership
• Oversee the performance of the sub acuture Rehabilitation centre to deliver a best-in-class service to all relevant stakeholders, meeting or exceeding all key performance areas and within budget
• Support cross RMA initiatives to drive improvements and improve efficiencies
• Eliminate obstacles facing staff, to make sure workloads are fairly spread, and to improve the overall work environment
• Evaluate the performance of direct reports against contracted performance targets, identify performance and developmental gaps and agree on personal development plans
• Promote a spirit of equality and non-discrimination and ensure that policies are implemented fairly and consistently
• Develop and maintain a work environment that recruits, retains, and supports high performing employees
• Participate, and encourage sub-ordinates to participate, in seminars, workshops, and conferences and online learning as identified in personal development plans
• Keep abreast of emerging trends in health care delivery; identify and define new and innovative strategies to achieve organisational goals and objectives
• Grow and maintain a strong medical community of practice and cultivate a learning culture amongst medical and administrative colleagues.

Requirements

WHAT YOU'LL BRING TO THE TABLE?

• Degree or Diploma in any of the therapy professions (Physiotherapy, Occupational Therapy, Social Work or Speech Therapy) or Relevant healthcare qualification
• NQF Level 9: Master’s Degree in an Accredited Healthcare or Insurance or Management Qualification
• Occupational Health qualification diploma /degree (DOH) will be advantageous
• Minimum 8 – 10 years clinical experience, which includes a rehabilitation environment or experience
• Experience in Rehabilitation of the injured preferred
• Experience managing a team of medical specialists
• Case Management experience advantageous
• Up-to-date knowledge of relevant OHS Act and Regulations, COIDA
• Up-to-date knowledge of OHS Act and Regulations, COIDA
• Demonstrate knowledge of and proficiency in rehabilitation services and modalities
• Case management knowledge and skill
• Exceptional communication skills: Listening, verbal and written
• Proficiency in Microsoft Office (Word, Excel, Outlook, and PowerPoint)
• Diagnostic, analytic, and problem-solving skills.
• Well-developed organisation and time management skills
• Ability to build and lead cohesive, successful team(s)
• Up-to-date registration with the Nursing Council or HPCSA (independent practitioner) / SACSSP
• Valid driver’s license
• Knowledge of business policies, processes and procedures, legal compliance.