The Durdoc Hospital is offering a great opportunity to suitable qualified and experienced staff to contribute towards our mission to improve the health of people and communities through innovation in Global Health. We are focused on researching, supporting and implementing integrated approaches to managing best health.

Education & Experience

A degree or Diploma in Nursing/ AEA
A post basic specialisation in Critical care / Emergency Nursing is preferred
Registration with the SANC as a Professional Nurse/ AEA with the HPCSA
At least 2 years’ experience within the Managed Healthcare funding / Risk
Management /Insurance Administration Industry
Experience within a Medical Assistance/Contact Centre environment
Experience or Knowledge in Provider Relations /Networks preferred
Co-ordination experience
Computer Literate
Core Competencies & Inherent Requirements

Good communication skills, verbal and written ( English first Language preferred and additional foreign language would be advantageous)
Report writing skills
Driver’s license
Set-up and Maintain on-going working relationships with Key Industry Partners key to the Medical Assistance function
Helpful, friendly and accommodating with a Customer focused attitude
Knowledge of Industry legislation and funding guidelines
Medical Aid/ Health Insurance products and benefits
Ability to apply knowledge of legislation to day-to-day work.
Initiate and implement processes.
Participate in protocol and process development.
Provide authorisation within the policy guidelines and benefit rules
Critical evaluation of information
Ability to identify potential claims risk.
Sound clinical decision-making ability with regards to Medical Assistance / Evacuation required as per information received
Collation of medical reports for review by Medical advisor/ Funder
Liaison, coordination and consulting with Clients and other Third Party providers is essential
Preparation of clinical status reports
Self-motivated, self-starter with a “go- getter” attitude
Critical, analytical
Assertiveness Life-long learner coaching

Duties and responsibilities:

Align Medical Assistance activities to the Strategic objectives of the International Business Unit.
Work closely with other team members to ensure alignment of activities within client SLA objectives.
Co-ordinate Medical Assistance Contact centre, pre-authorisation and medical evacuation functions and provide supervision and support to contact centre staff.
Ability to work shifts & extended hours/ be on-call as required.
Coordinate medical care within the most appropriate medical facility, referral to Medical Advisor & case management.
Quality Audit review of Closed Case files before reporting to finance for Client/ Third Party invoicing
Liaise with funders on funding decisions as required.
Assist with ad-hoc Medical assistance/ other delegated projects.
Provide daily management information reporting.
Implements new processes & protocols for clinical services as required.
Provide detailed feedback within the prescribed SLA timeframe to clients.
Investigates and provides feedback on service related matters to Senior Management and/clients as required.

Durdoc Hospital is a Joint Medical Holdings organization with substantial ambition and expectation to make significant impact to national systems in order to fundamentally change the way health is delivered on the continent. This is a unique and demanding opportunity to join an entrepreneurial, growing and purpose-driven team that share the mission of universal availability of medicines for all people in Africa.