Quality Assurance Coach - Pretoria - Pretoria
mna
A leading medical aid scheme company is seeking a Quality Assurance Coach to join their team. The successful candidate will manage and implement the various service quality assurance measures and quality improvement programmes across all aspects of service delivery, both clinical and operational in nature. They will identify training needs within all departments including, but not limited to, subject matter, systems or process knowledge gaps so that quality assurance outcomes and measures are achieved. They will be responsible for training and coaching staff based on the results of the quality measures and needs analysis – training may be done individually or within groups. Responsibilities: Design and implement a standardised quality management system/ programme. Perform quality assurance reviews per user in accordance with an agreed schedule. Compile and analyse audit reports to identify trends requiring quality improvement and/ or staff training. Conduct necessary training and/or coaching in conjunction with the relevant departmental Team Leader. Plan and conduct internal quality audits and follow-up on corrective actions as needed. Conduct quality awareness sessions with all employees. Perform route cause analysis on escalations received and implement mechanisms, processes, and system changes to improve quality outcomes. Identify process, policy, or rule limitations that require intervention and/ or change. Keep senior management informed of any matters or developments pertaining to legislation that may impact quality outcomes. Competencies: Minimum 2-3 years’ experience in a similar role within a medical scheme environment. Advanced computer skills with a demonstrated ability to analyse data, system workflows and processes. Proficiency with using MS SharePoint to share and manage documents and content, and to collaborate with team members. In-depth knowledge of Total Quality Management and an understanding of the differences between Quality Control and Quality Assurance. Excellent verbal and written communication skills. Excellent training/ coaching skills, including compilation and presentation of training materials. Knowledge of the South African Healthcare industry and prevailing legislation as well as coding structures i.e., ICD10’s, CPT4, NRPL, PMB conditions and clinical protocols. Knowledge of pre-authorisation, case management and client service processes within a medical scheme. Ability to liaise with external (clinicians and healthcare facilities) and internal (colleagues across all service areas) parties. Self-motivator and the ability to work effectively in an independent environment. Excellent administrative skills. Good organisational and task prioritisation skills. Outstanding multitasking skills High degree of accuracy and attention to detail Compile and submit relevant reports in accordance with strict deadlines. Results orientated. Qualifications: Business Management or Nursing diploma/ degree Accredited Certificate in Quality Management/ Quality Assurance and/ or Training Candidates that meet the criteria may submit their applications via this portal or via the vacancy link on www.mnarecruitment.com Should you receive no feedback within 7 days, please accept your application as unsuccessful.
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