Enrolled Nurse: Senior Officer

Enrolled Nurse needed for a Senior Officer Non-Disclosure Investigations vacancy for a Managed Healthcare organization. Candidate must have managed healthcare experience.

Education, Training and Experience

• Grade 12
• Registered at SANC as an Enrolled Nurse.
• Two (2) years applicable experience in Managed Healthcare.
• Computer literate in MS Office.
• Successful completion of the selection process based on criteria that determine the candidate’s potential with regard to the following competencies:
• Customer focus;
• Business insight;
• People development;
• Building trust and credibility;
• Teamwork.

Key performance areas

• The investigation officer is responsible for all cases where a possibility of non-disclosure of existing health conditions exists, and also whether previous procedures or treatment performed on the member and/or dependent during the preceding 12 months the scheme was declared.
• Determine the degree of financial risk for the scheme.
• Collection of necessary information, clinical, membership and historically information from the service providers, family and brokers.
• Contact relevant service providers and/or member to obtain information regarding the patient’s condition.
• Give feedback to interested parties such as brokers during the course of investigation.

Only short listed applicants will be contacted. Applicants, who have not been contacted within 2 - 3 weeks of the closing date, should assume that their application has not been successful.
SM Placements is an equal opportunity employer.