Minimum Education: Matric

Minimum Experience: Registered Nurse with HIV experience

Registration Required: Registration with the South African Nursing Council

Duties and Requirements includes but is not limited to the following:

Member retention and customer services
Maintain risk profile of members enrolled on Disease Management Programmes
Ensuring continuous improvement and process improvement
Production of educational material and dissemination to patients
Retrospective review of related claims
Developing and maintaining clinical protocols including new drug reviews
Working with other healthcare personnel within the organisation
Liaising with pharmaceutical companies
Compilation of monthly reports detailing programme progress and areas of cost containment
Keep abreast of benefit changes
Develop and deliver educational presentations to employer groups

Other Requirements:

Excellent knowledge of Chronic Disease treatments and procedures
Knowledge of Clinical Protocols
Knowledge of Prescribed Minimum benefit protocols and algorithms would be an advantage
Medical aid / managed healthcare experience is an advantage
Experience in disease management is an advantage

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