Diabetes Case Manager - Gauteng, Sandton - Sandton
Che Leigh Personnel Consultants
Purpose of the Job Constant & ongoing development of the Disease Management Programme Reduction of risk by facilitating treatment authorization Key Performance Areas (KPAs) Member retention and customer services Maintain risk profile of members enrolled on Disease Management Programmes Ensuring continuous improvement and process improvement Job key responsibilities 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 To keep abreast of benefit changes To develop and deliver educational presentations to employer groups. Other ad-hoc duties Current knowledge of the following: Excellent knowledge of Chronic Disease treatments and procedures Clinical Protocol Knowledge of Prescribed Minimum benefit protocols and algorithms would be an advantage Qualification/s Matric Registration with the South African Nursing Council Registered Nurse with Diabetes experience Medical aid/ managed healthcare experience an advantage Experience in disease management an advantage Experience Progression Required 1-2 years medical aid/ managed healthcare experience would be an advantage Diabetic Nurse Educator experience Desired Skills: diabetes nurse
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