Job Openings at Discovery Limited

Key Purpose

Design and implement robust, scalable and optimally performing systems using java related technologies, according to provided specifications, standards and procedures, while ensuring compliance with the architectural standards and guidelines laid out by Discovery.

Areas of responsibility may include but not limited to

Design:

• Translate business requirements into technical designs adhering to Discovery Insure processes, standards and guidelines, taking cognisance of performance, security and scalability requirements. Deliver within agreed timeframes. Complexity = number of interacting components within a single system, simple integration between diverse systems.
• Liaise with relevant parties where clarification of business requirements or resolution to technical issues is needed
• Research and find effective solutions to technical issues that arise
• Estimate development timelines based on business requirements
   

Development:

• Construct robust, maintainable, scalable, optimally performing system code in line with technical specifications, following prescribed process, standards and procedures.
• Deliver within agreed timeframes
• Conduct unit testing and fix any defects found

Testing:

• Verify build stability and quality with development team before releasing to test team, aiming to release with zero defects
• Assist the Business analyst in ensuring the test pack includes relevant scenarios
• Consult and assist in reviewing risk / impact of defects found in testing, and assist with fixing where necessary

Support / Troubleshooting:

• Assist system users with technical support issues and handle according to defined procedures
• Ability to effectively analyse root cause of system errors (front end and data errors, performance and stability issues)

Mentoring / Team development:

• Actively coach other developers to understand and apply the Insure coding and architectural standards correctly, as well as any technologies in use
• Perform code / peer review to ensure logical correctness, maintainability, scalability, performance, compliance with architectural standards and frameworks

Personal development:

• Keep abreast of current technological trends and how these might be applied in the Discovery environment
• Constant improvement of knowledge of the various applications, their functionalities and data models
   

General:

• Ability to communicate clearly, constructively and effectively. Easily able to follow and participate in technical, business process, and other discussions
• Able to build business relationships with other members of team and the business areas we support

Education

• Grade 12 and formal Java qualifications
• BSc Computer Science/Information system degree – Advantageous
   

Experience

• No previous internship and or graduate programme in any industry or government institution
• No work experience (Essential)
   

EMPLOYMENT EQUITY   
                             
The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.

go to method of application »

Key Purpose

• The key purpose of this role is to administer Group Risk policies, reconciling scheme and reassurance premiums and to handle all queries relating to any of the above with external and internal clients

Areas of responsibility may include but not limited to

• Processing of all daily and monthly transactional activity within agree service levels.

• Process data comparison to prepare reconciliation of premiums to ensure that the client is applying correct rates against internal billing.

• Liaison with both internal and external clients to ensure resolution of client queries (TWT); as per SLA

• Responsible for entire billing process including monitor monthly billing, contributions allocation and sending statements

• Compare bank statement against scheme batch remits to ensure the accurate allocation of payments/premiums to correct schemes.  Issue credit control where necessary.

• Handling of general admin queries

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

• Team work and analytical skills

• Communication

• Problem solving

• Initiative and enterprise

• Learning

• Technology

Education and Experience

• Matric - essential

• MS Office – Especially Excel Skills,

• Group Life /Risk Insurance experience- and advantage

• Full compliance and legislative universe relating to employee benefits, FAIS and Umbrella Funds.

• 3 -5 years’ experience within a Group Life Administration environment

Employment Equity  

The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.

EMPLOYMENT EQUITY   
                             
The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.

go to method of application »

Job Purpose:

This role intends to ensure that entities data is accurate, valid, complete and conforms to the relevant data quality standards and adheres to the Protection of Personal Information Act (POPIA), for Health and  branching to the other Discovery businesses. This role is accountable for data quality governance across the Group, access governance and data privacy support,by serving as the link between Risk, Systems, Compliance, Business and Data Integrity.

Principal Accountabilities:

• Report on predefined data quality governance and metrics to business, manager and the Group Information as well as the  Privacy officer on a monthly basis.

• This role will be extended to Health Provider Admin, Workpool and Access Centre teams, financial consultant entities and staff entities as well as support for Data Privacy in relation to data analysis, root cause analysis and data quality rules where necessary.

• Analyse and review data quality governance-related policies, using supporting frameworks and tools, root cause analysis . Identify gaps in Discovery’s data  and make recommendations for potential process changes within business. Reporting on business adherance to data quality governance rules and policies.

• Refine and optimize data processes when it comes to specific data rules and business processes.

• Provide business with the relevant data extracts, dashboards and insights to fix the data using PL/SQL and IBM Infoshpere. Ensuring that the relavent fixes are done by the relevant business area.

• Attending and presenting at weekly/monthly data governance, data privacy forums and technical data governance working groups and provide input as the subject matter expert for entity data.

• Chair the Group Data Quality Governance forum as well as all business working groups related to group data quality governance. Attend Fraud Forum  and drive a culture of data quality throughout the Discovery group.

• Continuously monitor the entities data set, identify anomalies and missing data through the relevant data analysis processes.

• Use entity cross company analytics, vaccine data and data from third party vendors to provide business with the most recent data on its entities. Be the Data Steward and subject matter expert for entity data. Know the rules behind entity creation and ensure all areas adhere to these rules.

• Work with CareConnect to create a unified member data record on the Health Information Exchange with the relevant health founding members such as Netcare and Mediclinic.

• Assist the Deputy Information Officer of Discovery Health to investigate privacy incidents and breaches.

• Calculating charge outs and doing ABC costing models for work done for other companies.

Essential Qualifications / Education:

• Matric

• Degree in an analytics field such as Business Analysis, Data Science, Maths, Statistics or Economics

• SQL certification

Advantageous Education / Qualifications:

• Honours Degree in an analytics field such as Business Analysis, Data Science, Maths, Statistics or Economics

• Six Sigma Green Belt

• Master Data Quality Management certification

• R Certification

Essential knowledge:

• Advanced SQL

• Advanced Excel and PowerPoint

• Data analysis synthesis

• Understanding of entities, provider and access governance systems

• Understanding data quality and data governance concepts

Advantagous knowledge

• Advanced Power BI

• SharePoint

• Paradigm

• IBM Infosphere

Essential Experience:

• 2 years Data Analyst experience

• 3 years Project management experience

• 1 year Process design and improvement experience

Advantageous Experience:

• Prior data quality governance experience

• Prior leadership experience

• Experience in Data Integrity, Privacy and data governance

• Change Management experience

EMPLOYMENT EQUITY   
                             
The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.

go to method of application »

Key Purpose:

• Managing the risk relating to In hospital admissions, through the application of clinical and coding knowledge, protocols, legislation, standard operating procedures (SOP’s), service level agreements (SLA’s) and the member’s benefit structure. The role will apply to working in various settings, predominantly casualty. It is anticipated that the risk purpose will also extend into the general ward and high care/ICU settings as needed.
• Coordinating the care of certain patients who are vulnerable to care gaps during transitions particular entry into hospital through to the emergency room, and discharge from hospital. The populations most vulnerable to gaps in care during transitions include clinically high risk patients; patients undergoing major surgical procedures; and patients with low socio-economic circumstances.

Please note: The successful applicants will be based at a designated hospital within the applicable region.

Principal Accountabilities:

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 approving or declining treatment to ensure that the member gets the appropriate level of care
• Discharge planning by providing the member with alternatives to receive treatment
• Effective and accurate communication to all stakeholders
• Case update to the provider
• Funding decisions and Benefit confirmations to the members
• Request for additional information from the treating doctor
• Systems teams (issues experienced)
• 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
• Quality of processes
• Onsite perception survey

Personal Attributes:

• Composure - Is cool under pressure; does not become defensive or irritated when times are tough; is considered mature; can be counted on to hold things together during tough times; can handle stress; is not knocked off balance by the unexpected; doesn't show frustration when resisted or blocked; is a settling influence in a crisis.
• Conflict Management - Steps up to conflicts, seeing them as opportunities; reads situations quickly; good at focused listening; can hammer out tough agreements and settle disputes equitably; can find common ground and get cooperation with minimum noise.
   
• Decision Quality – Makes good decisions (without considering how much time it takes) based upon a mixture of analysis, wisdom, experience, and judgment; most of his/her solutions and suggestions turn out to be correct and accurate when judged over time; sought out by others for advice and solutions.
• Integrity and Trust - Is widely trusted; is seen as a direct, truthful individual; can present the unvarnished truth in an appropriate and helpful manner; keeps confidences; admits mistakes; doesn't misrepresent him/herself for personal gain.
• Negotiating - Can negotiate skillfully in tough situations with both internal and external groups; can settle differences with minimum noise; can win concessions without damaging relationships; can be both direct and forceful as well as diplomatic; gains trust quickly of other parties to the negotiations; has a good sense of timing.
• Perseverance - Pursues everything with energy, drive, and a need to finish; seldom gives up before finishing, especially in the face of resistance or setbacks.
• Problem Solving - Uses rigorous logic and methods to solve difficult problems with effective solutions; probes all fruitful sources for answers; can see hidden problems; is excellent at honest analysis; looks beyond the obvious and doesn't stop at the first answers.

Education and Experience:

The following requirements are essential:

• Matric
• Must be a Registered Nurse
• Valid SANC 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
• 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

EMPLOYMENT EQUITY   
                             
The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.