Specialised Health Care Coach (Cape Town and Centurion) at Momentum Metropolitan Holdings Limited

Role Purpose

• To manage the clinical risk of patients through the authorisation of clinically appropriate treatment and outbound interventions.

Requirements

• Matric
• Nursing Diploma or Degree essential
• Minimum of 4 years of clinical experience essential
• Registered with SANC essential
• Experience in managed health care would be advantageous

Duties & Responsibilities

• Liaising with patients, providers and Disease Management companies.
• Answering and assisting with all queries related to disease management programmes.
• Following up on decisions with Providers and/or 3rd parties.
• Maintaining relationships with 3rd parties.
• Monitoring the progress of patience on disease management programmes.
• Assisting with early detection programmes and advocating available preventative health benefits to better manage risk.
• Facilitating reports to the scheme.
• Initiating outbound contact with patients and providers where appropriate.
• Educating and guiding all members regarding health care and their benefits.
• Authorising appropriate and cost-effective medical care and treatment.
• Applying set Clinical Guidelines and policies.
• Possible identification of clinical guidelines.
• Identifying all compliance risks.
• Supporting budget control and cost containment of health management programmes.
• Assisting with registration on various programmes to ensure the quality of life for patients with life-threatening diseases.
• Dealing promptly with client requests in a competent, efficient and professional manner.
• Liaising with specialists to gain their insight into assessing risks.

Competencies

• Accountability
• Planning
• Organization and Attention to Detail
• Customer orientation
• Empathy
• People skills
• Teamwork and Cooperation
• Business Administration
• Results Orientation
• Policy