Current Openings at Discovery Limited

Key Purpose:

The successful applicant will be responsible for but not limited to the following job functions:

Assessing the case in relation to the following:

• Members clinical history
• Members benefit structure
• Clinical Information and coding supplied
• Level of care provided
• Appropriateness of the facility
• Appropriateness of the treating doctor
• Appropriateness of treatment
• Managing the benefit for the member and the risk for the relevant scheme through a thorough process to approve or decline Funding to ensure that the member gets the appropriate level of care
• Discharge planning by providing the member with alternatives to receive treatment (This includes Hospital @ Home, Homecare etc.)
• Effective and accurate communication to all stakeholders:
• Case update to the provider
• Funding decisions and benefit confirmation to the members
• Request for additional information from the treating doctor or practice manager
• Engaging with Patient Services Manager and hospital staff
• Handling escalations from Providers and internal stakeholders
• Preparing and presenting complex case to clinical review
• Trend Analysis of inefficiencies and proposals to correct
• Appropriate internal case referrals for clinical management

Operational Targets:

• Attend to patients on daily report
• Review all low acuity admission requests
• Quality of processes

Competencies:

The successful candidate must demonstrate the following competencies:

Role Specific Behaviours

• Ensures accountability.
• Action oriented
• Manages ambiguity.
• Attracts top talent.
• Business insight
• Collaborates
• Communicates effectively.
• Manages complexity.
• Manages conflict.
• Courage
• Customer focus
• Decision quality
• Develops talent
• Values differences
• Directs work.
• Drives engagement
• Financial acumen
• Global perspective
• Cultivates innovation.
• Interpersonal savvy
• Builds networks.
• Nimble learning
• Organizational savvy
• Persuades
• Plans and aligns.
• Being resilient

Resourcefulness

• Drives results
• Demonstrates self-awareness.
• Self-development
• Situational adaptability
• Balances stakeholders
• Strategic mindset
• Builds effective teams.
• Tech savvy
• Instils trust.
• Drives vision and purpose
• Optimizes work processes

Education and Experience:

The following requirements are essential:

• Matric
• Must be a Registered Nurse or Clinical Associate
• Valid SANC Registration or HPCSA registration
• 3 years Clinical experience in a private hospital setting (ICU, Trauma/Casualty, Medical/General ward preferable)
• 2 years Managed health care experience 
• Microsoft Office (Specifically Excel experience)
• Valid Driver’s License and own transport ( working hours are between 08:30 -17:00 & travel up to 50KM may be required)
• Effective Communication Skills (Verbal & Written)
• Telephone Etiquette
• Active Listening Skills

The following requirements will be advantageous:

• 1 – 2 years ICU experience
• Knowledge of DH SOP’s and Process experience (internal only)
• Provider payment arrangements (internal Only)
• Clinical coding knowledge of ICD-10 and/or CCSA

Personal Attributes or Competency Profile

The Discovery Person

• Values Driven
• Optimistic
• Learns on the Fly
• Resilient
• Instils Trust
• People Savvy
• Drives Results
• Problem Solver
   

go to method of application »

Areas of responsibility may include but not limited to

Wealth Management:

• Telesales, Administration, Data analytics, Compliance, lead prequalifying, Quoting, client servicing, claims, pre-sale underwriting and new business,

Personal Attributes and Skills

• Innovative/ critical thinking/ and problem-solving skills
• Good attention to detail and levels of accuracy
• Sets high standards for quality and quantity and works in a systematic, methodical and orderly manner.
• Time management and planning skills
• Ability to effectively prioritize and execute tasks in a high-pressure environment
• Ability to work independently and in a team orientated environment
• Service driven, a sense of urgency and a team player.
• Adapts to changing circumstances and handles criticism well and learns from it.
• Speaks fluently and writes in a well-structured and logical manner.

Education and Experience

• Grade 12 is essential.
• Maths (Minimum Level 4 – 50%)
• English (Minimum Level 4 – 50%)
• Maths Literacy (Minimum Level 5 - 60%)
• 2nd language (Minimum Level 4 – 50%)
• May have an incomplete tertiary (financial) qualification (advantage)

Specific Requirements:

• Not be engaged in post Matric studies or formal employment;
• Not have completed any previous Learnership.
• Be between the ages of 18 and 30 years;
• Have effective communication skills in the written & verbal English language;
• Possess basic computer skills mainly MS Excel & MS Outlook
• Only South African candidates by birth will be considered.
   

go to method of application »

Key Purpose

• To increase the sales of the Discovery Health product range through strategic consulting, business partnership and relationship management, superior client service and technical expertise.

Areas of responsibility may include but not limited to

• Strategic consulting to large, national intermediaries, guiding Health new business growth
• Drive and implement strategic new business initiatives with intermediaries and employers 
• Relationship management at Board, Executive and Senior Management level
• Manage national intermediary relationships, offering guidance and mentoring to BCs within the team to drive a national strategy
• Project manage complex, new business implementations from end to end.
• Project plan and participate in proactive sales and marketing initiatives
• Leverage off health relationships to trigger integration opportunities across the Discovery product suite
• In depth strategic reporting
• Industry, competitor and product expert
• Technical support with competitor crosswalks, industry analyses, technical product detail
• Relationship management with internal stakeholders and representation of Corporate Distribution in various forums
• Escalated, complex query resolution
• Keep abreast of competitor products, service offerings and industry developments

Competencies

• Strategic thinker & solution orientated
• Logical, analytical problem-solving ability.
• Excellent interpersonal skills.
• Excellent verbal and written communication skills.
• Ability to work independently.
• Ability to take accountability, responsibility, and ownership.
• Able to take initiative and exercise sound judgment and decision making.
• Ability to work in a highly pressurised, target oriented environment.
• Ability to deal positively with change and uncertainty.
• Strong business acumen.
• Strong sales and persuasive skills.
• Strong quality orientation.
• Good organisational skills.
• Proactive, self-motivated.
• Customer oriented.

Education and Experience

• 3-5 years medical scheme industry experience (required)
• Business degree (advantageous)
• RE5 (preferable)
• NQF5 in Wealth Management of Financial Planning / 120 FAIS credits (preferable)
• Knowledge of MS Office Suite
• Sales experience (advantageous)
• Knowledge of MS Office suite

go to method of application »

Key Purpose

• This role is in the high-performing Group Risk actuarial team, responsible for the pricing, reinsurance, retention and risk management for over 2 500 employer clients, 700 000 members and R3.2bn annual premium. This role will focus on the cleaning and processing of data for internal functions. Subsequent analysis of this data will also be necessary for this role.

Areas of responsibility may include but not limited to

• Liaising with internal teams, accounting, valuations, systems implementation, systems, operational teams, pricing and technical marketing.
• Communicating with internal pricing and sales teams to create appropriate presentations for clients.
• Communicating with the reinsurer for the monthly reinsurance premiums and other functions. 
• Working with senior team members to clean and process the data appropriately for basis reviews and ad-hoc investigations.
• Using knowledge of internal data processes and sources to support data remediation where needed.
• Ad-hoc investigations to support business decisions.

The role offers the opportunity to develop where further areas of responsibility include:

• Review of pricing bases.
• Presentation of pricing bases to internal stakeholders.
• Presentation of ad-hoc investigations to internal stakeholders.
• Presentations to clients for renewal discussions

Personal Attributes

• Highly analytical
• Delivering results and meeting customer expectations
• Planning & organizing
• Speed and accuracy
• Competent and reliable
• Willingness to learn and share ideas
• Good communication skills
• Self-starter attitude
• Deadline driven

Education and Experience

• Actuarial Science degree
• Student of ASSA
• Understanding of insurance and the risks around data (Advantageous)
• Experience in data analysis recommended
• Programming in R, SQL and VBA recommended
   

go to method of application »

Key Purpose

• The position is responsible for the day-to-day administration and managing a small team within Group Life Operations. This is a core administration function and the incumbent would be required to holistically manage and control a portfolio of different Group Life disciplines, for example monthly contribution, claim, investment option, individual transfer in, section 14, section 28 processes. The incumbent must ensure that processes and procedures are implemented, maintained and improved. The incumbent needs to ensure operational activity is conducted within regulatory frameworks, accurately, effectively and efficiently. The incumbent must ensure that he/she has the knowledge, skills, tools and competencies required to perform the required job within service level agreements. The incumbent must have an appetite to be part of a growing new business unit, continuous improvement, able to adapt to change easily and play a role in change management within the team, challenge the status quo, inspire and motivate others. The incumbent will continually review existing processes and procedures in order to ensure the delivery of committed services to the Group Life Clients.

Areas of responsibility may include but not limited to

• Prepare monthly claim reports
• Analyse the claim reports and query where necessary
• Liaise with the Administration department to confirm sum assureds, credit control and member covers.
• Handle claim related queries as well as assist with Call Centre overflow.
• Drafting of letters as and when required
• Investigate and resolve actuarial queries.
• Register data checks daily and monthly.
• Investigate reason for query.
• Maintain and have records updated.
• Request for various data from the systems and business areas.
• Collate and compare data.
• Daily reporting.
• Daily comparisons between various system extracts ( cognos, register extract, paradigm extracts, payments etc).
• Daily summary findings based on the comparisons.
• Resolutions to summary findings.
• Resolution of actuarial data queries within a short timeframe.
• Resolution of register data queries within a short timeframe.
• Follow up on outstanding data query resolution.
• Provide regular status updates.
• Daily register validation checks.
• Maintain, death, funeral and disability payment registers.
• Process Ad-hoc payments as and when required.
• Partake in adhoc projects/tasks assigned by Management.

Personal Attributes

• Leading and Supervising
• Planning & Organizing skills
• Working with People - Communication
• Persuading and Influencing
• Adhering to Principles and Values – Self management
• Delivering Results and Meeting Customer Expectations
• Coping with Pressure and Setbacks
• Relating and Networking
• Teamwork and analytical skills
• Communication
• Problem solving
• Initiative and enterprise
• Learning
• Technology

Education and Experience

• Grade 12 and further studies are advantageous.
• Telephone etiquette, detail orientated and self-driven.  
• Customer centric focus to be evident.
• MS Office; Compass
• 3 – 5 years claims experience in the long term insurance industry. 
• Pension and Provident Fund experience is advantageous.