Manager WESTVILLE - Westville
Private Health Administrators
To manage the Hospital Benefit Management Department, provide clinical oversight and training, incorporating the philosophy of Demand Management. To identify areas of clinical risks and assist in mechanisms of addressing these risks. In addition, to assist the Clinical Care Coordination Senior Manager with client specific projects. KEY PERFORMANCE AREAS Understand and add valuable input into the Scheme's managed care strategy Communicate the managed care strategy back into the operational environment Proactively identify any potential clinical risks relating to contracted services, and coordinate an appropriate response or action plan from the expert areas within the company to address the identified risk Effectively present the relevant managed care reports for the schemes Articulate the value of the managed care solutions Ensure that the necessary action items from the managed care sub-committees are appropriately attended to. Articulate the schemes strategy and intention from new initiatives and collaborate with operational units to ensure that there is a clear understanding of what the scheme requires. Competency Requirements Attributes Influence: Engage with Customers and colleagues to advance the organisation's welfare Entrepreneurship: Take chances to continuously improve our Customer's experiences Driving operational efficiencies Credibility: Lead with integrity and trust others as you would like to be trusted Ownership: Make critical decisions based on what's right for the company and Customers Owning operational decisions and knowing oneself Collaboration: Build work-related networks and share knowledge with colleagues Knowledge Knowledge and application of processes and procedures Knowledge and application of relevant legislation Product and scheme rule knowledge Skills Analytical Ability Numerical Ability Attention to Accuracy and Detail Business Writing Skills Report Writing Skills Problem Solving Computer Technology Skills Customer Focus Communication Skills Experience: 5 - 8 years relevant managed care, health risk and clinical customer service Qualifications: 3 or 4 years Medical degree/qualification MARKET RELATED CTC PACKAGE PENSION FUND MEDICAL AID PERFORMANCE BONUS
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