based in Pretoria, has a Permanent vacancy for a Member Care Clinical Consultant (Pre-Autorisation).
Job
Job Purpose:
The role of a Member Care Clinical Consultant (Pre-Authorisations) involves
incoming calls from healthcare service providers and members/ beneficiaries.
and related activities in the safe space and community. In particular, the Psychosocial Assistant is camp and ensure effective case management. In addition, S/he will work and liaise closely with the GBV EYN and other partner agencies. Conducting PSS community dialogue with the wider population about issues Supporting the GBV officer and GBV caseworkers during Community GBV prevention forums and meetings. Promoting interact in a professional way, including community members, clients, and partners. The candidate should
responsible for ensuring that members receive an excellent fitness experience. Additionally, Pro should act in a duties such as answering phone calls and handling member queries
of chronic registration letters to Providers, Members and Pharmacies Sending formulary lists to treating Contacting of treating providers, members and pharmacies to register members on programmes Copy notes from provider details Update Pathology results Update member contact details on MIP system Upload documents service orientation Patience and a calm manner Additional languages advantageous Results orientation High
of chronic registration letters to Providers, Members and Pharmacies Sending formulary lists to treating Contacting of treating providers, members and pharmacies to register members on programmes Copy notes from provider details Update Pathology results Update member contact details on MIP system Upload documents service orientation Patience and a calm manner Additional languages advantageous Results orientation High
reports for submission
JOB PURPOSE The role of a Member Care Clinical Consultant (Pre-Authorisations) involves ensuring that incoming calls from healthcare service providers and members/ beneficiaries. Verification of the eligibility beneficiary if caller is not able to assist. Refer to member management (case management) if co-morbid conditions for escalation to member management for discussion and resolution. Provide member care and education liaise with external parties – clinicians and members – and to make decisions. Demonstrated ability to
incoming calls from healthcare service providers and members/ beneficiaries. ● Verification of the eligibility if the caller is not able to assist. ● Refer to member management (case management) if co-morbid conditions for escalation to member management for discussion and resolution. ● Provide member care and education liaise with external parties – clinicians and members – and to make decisions ● Demonstrated ability Proficiency in English – written and verbal (an additional language will be advantageous) ● Ability to research
collection strategies are adhered to by staff members;