Jobs at Kaelo

Responsibilities include:

Team Lead Specific Duties

• Develop and maintain reports of daily activities, present analysis and feedback to the Clinical manager.
• Perform monthly Quality Assurance Audits for the team.
• Allocate daily roles and activities to team members based on demand and capacity.
• Where applicable, ensure that the team are appropriately allocated to afterhours duties, and maintain a record of timesheets to be submitted to the line manager for remuneration of afterhours activities.
• Ensure the team is meeting their specified SLA for all daily activities, where inefficiencies or issues are noted these must be raised to the line manager immediately.
• Ensure GP authorisations are loaded accurately and completely according to company standards and policies.
• Training and coaching the team (including but not limited to: company policies and standards, product rules, clinical guidelines) to ensure high-quality clinical care management services are provided.
• Communicate with the Health Service Cantre Manager to ensure operational efficiencies between the Health Service Centre and virtual care teams.
• Provide input and support for projects as required by the business

Daily operational activities

Virtual care bookings

• Ensure that the team calendars are appropriately opened and/or blocked according to the tea, availability and scheduling
• Ensure that members are being consulted as scheduled
• Manage any escalations related to consultations
• Consulting patients together with the team during the available time slots
• Weekly reporting of bookings and consultations

Clinical triage queue

• Ensure availability of a team daily who is responsible for the calls being transferred from the call centre
• Ensure the tracker is completed daily
• Ensure accurate call tagging
• Report on weekly summary or tracker

Administrative duties

Line management of virtual care nurse team

• monthly
• Leave management
• Training and development
• Scheduling of Drs according to their availability
• Act as a liaison for the VC doctors
• Quality auditing
• Rostering and scheduling

General

• Report any clinical escalations/concerns to the Clinical Review Committee or clinical risk management teams
• Maintain confidentiality in clinical conditions shared with her/him.

Key outcomes

• Assist the Clinical and Medical Advisors to identify appropriate resources and guidelines to effectively assess, prioritize, advise, and manage patients presenting with a variety of primary healthcare conditions, including but not limited to: Common acute and chronic outpatient conditions, emergency conditions, HIV, maternity and family planning, child care.  
• Ensure all team members thoroughly complete documentation utilizing the appropriate computer software in compliance with the approved policies and procedures.
• Ensure all team members maintain current nursing skills and knowledge base by attendance at workshops and seminars, completion of mandatory continued professional development, reading of professional journals, publications, and participation in professional organizations.
• Develop and maintain reports on the activities carried out within their team, presenting feedback and analysis of targets and outcomes.

Qualifications

EDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED

• Professional Nurse / Registered Nurse / Enrolled Nurse / ALS paramedic
• Degree / Diploma in Nursing
• A minimum of 5 years nursing experience.
• Experience across both the public and private health sector.
• Medical Aid or Insurance industry experience will be an advantage.
• Knowledge of ICD codes.

DESIRED

• PHC, Midwifery, and HIV experience is an advantage.

TECHNICAL SKILLS OR KNOWLEDGE

REQUIRED

• Strong understanding of clinical codes.
• Attention to detail.
• Health risk assessment knowledge.
• Computer Literacy (Microsoft office). 

Additional Information

PERSONAL ATTRIBUTES: BEHAVIORAL COMPETENCIES

• Accountability for clinical decisions made.
• Communication with all related health care workers, patient, and next of kin involved in a case.
• Writing skills-for clear and concise notes that are easy to understand.
• Efficient and effective mindset to make clear clinical decisions without prejudice and interfering personal beliefs.
• Planning and organisation of work.
• Resilient and adaptive to different environments.
• Prioritizes patient care
• Self-development
• Ethical always maintaining professional image and language.
• Team player

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Team Lead Specific Duties

• Develop and maintain reports of daily activities, present analysis and feedback to the Clinical manager.
• Perform monthly Quality Assurance Audits for the team.
• Allocate daily roles and activities to team members based on demand and capacity.
• Where applicable, ensure that the team are appropriately allocated to afterhours duties, and maintain a record of timesheets to be submitted to the line manager for remuneration of afterhours activities.
• Ensure the team is meeting their specified SLA for all daily activities, where inefficiencies or issues are noted these must be raised to the line manager immediately.
• Supervise and report on the clinical auditing of claims conducted by the team
• Training and coaching the teams (including but not limited to: company policies and standards, product rules, clinical guidelines) to ensure high-quality clinical care management services are provided.
• Training for Netcare 911 teams
• Communicate with the Health Service Cantre Manager to ensure operational efficiencies between the Health Service Centre and Case Management team  
• Provide input and support for projects as required by the business

Daily operational activities

Case Management Team

• Ensure team is correctly and accurately allocated to cover all shift s.
• Assist team with Clinical decisions and escalations
• Draft and update Clinical SOP’s
• Guide team on funding decision based on product differences
• Review long term cases are correctly allocated and scheduled
• Review High-Cost cases received  weekly
• Review report sent daily, weekly and monthly.

HIV Patient Management team

• Check the maintenance of Service level
• Train team on latest guidelines to medication and protocol
• Update the SOP’s
• Review all Provider, system and patient escalations
• Keep  abreast with the latest guidelines

Administrative duties

Line management of Case Management and Patient Management team

• monthly
• Leave management
•  Refresher team Training and development
• Quality auditing
• Rostering and scheduling

General

• Report any clinical escalations/concerns to the Clinical Review Committee or clinical risk management teams
• Maintain confidentiality in clinical conditions shared with her/him.

Key outcomes

• Assist the Clinical and Medical Advisors to identify appropriate resources and guidelines  based on the latest trends to improve patient access to treatment and effective curative processes and care .  
• Ensure team maintain the correct standard of care with valid level of acuity and care at designated facilities.
• Ensure all team members maintain current nursing skills and knowledge base by attendance at workshops and seminars, completion of mandatory continued professional development, reading of professional journals, publications, and participation in professional organizations.
• Develop and maintain reports on the activities carried out within their team, presenting feedback and analysis of targets and outcomes.

Qualifications

EDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED

• Professional Nurse / Registered Nurse / Enrolled Nurse / ALS paramedic
• Degree / Diploma in Nursing
• A minimum of 5 years nursing experience.
• Experience across both the public and private health sector.
• Medical Aid or Insurance industry experience will be an advantage.
• Knowledge of ICD codes.

DESIRED

• Hospital ICU and theatre experience.
• PHC, Midwifery, and HIV experience is an advantage.
• Knowledge of PMB and DTP’s

TECHNICAL SKILLS OR KNOWLEDGE

REQUIRED

• Strong understanding of clinical codes.
• Attention to detail.
• Health risk assessment knowledge.
• Computer Literacy (Microsoft office).

Additional Information

PERSONAL ATTRIBUTES: BEHAVIORAL COMPETENCIES

• Accountability for clinical decisions made.
• Communication with all related health care workers, patient, and next of kin involved in a case.
• Writing skills-for clear and concise notes that are easy to understand.
• Efficient and effective mindset to make clear clinical decisions without prejudice and interfering personal beliefs.
• Planning and organisation of work.
• Resilient and adaptive to different environments.
• Prioritizes patient care
• Self-development

go to method of application »

Job Description

To provide excellent new business delivery and quality through Kaelo service and sales standards. Identifying and improving the outcomes of new business activities. Increase and drive new business with a focus on quality and retention. Improving efficiencies and optimising new business acquisitions and drive increased revenue. Increasing the sales of our product offering through building relationships, superior client service and technical knowledge.

• Manage strategic new business accounts and maintain relationships for the business. Build and maintain client portfolios
• Build long term relationships with new and existing clients
• Ensuring all administration relating to sales is completed effectively
• Provide sales solutions to meet clients’ needs
• Participate in proactive sales and marketing initiatives
• Drive value stream mapping to define as-Is analysis and the transition to Future State
• Application of knowledge; technical training and analysis to upskill prior to going to market
• Keeping up to date with competitor products and service offerings and industry developments
• Develop and enhance relationships between business units
• Working closely with other business areas and finding opportunities to cross sell
• Strategic prospecting skills and rapport building
• Negotiate and close sales

Qualifications

• Minimum of 3 years as a Business Development Consultant with a proven track record of meeting sales targets

PERSON DETAILS: WORK EXPERIENCE

REQUIRED

• Health industry knowledge
• Short Term Insurance knowledge
• Top performer in new business and sales team
• Proven ability to drive sales and generate new business
• Sales Campaign management
• Strategic management with focus on marketing enablers
• Continuous improvement and strategic experience
• Confident and experienced negotiator able to drive revenue

PREFERRED

Based in JHB

EDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED

FAIS

• Grade 12 matric
• NQF Level 5 Wealth Management or short-term insurance

RE exams

PREFERRED

• Business Degree

TECHNICAL SKILLS OR KNOWLEDGE

REQUIRED

• Strong programme and Microsoft office management tool skills
• Knowledge of underwriting processes
• Understanding of financial planning
• Relevant industry experience and competitor knowledge
• Exceptional communication skills both verbal and written, problem solving and analytical skills

Additional Information

• Accountability
• Action orientated
• Collaborative
• Communication
• Business writing skills
• Manage complexity
• Problem solving skills
• Decision thinking
• Encourages engagement
• Resilient and adaptive
• Resourceful
• Demonstrates self-awareness
• Purpose driven
• Significance and values orientated