Must handle members and providers professionally

Daily planning and organisation in line with defined targets stipulated in the Health Returns Model

Accountability for daily work load in terms of referrals to chronic for potential CDL unwell members

Management of HA unwell members

Work with individual and mainly healthy beneficiaries of the scheme to achieve better health outcomes while helping beneficiaries to understand their disease and health status.

Move from HA unwell to HA well.

Empower the patient by helping him/her to explore the triggers that are responsible for risk of ill health and potential deterioration and improvement in health status.

Reduce the downstream clinical and financial risk associated with the beneficiary

Display excellent communication- and telephone skills on a daily bases

Keep detailed records of patient interaction and follow ups done by updating system records

Ensure the effective, accurate and timeous completion of relevant documentation accompanying transactions

Produce tangible evidence of interventions made and the outcome thereof

Real time provider interaction and decision making is essential

Perform an efficient and accurate administrative function.

Identify all compliance risks.

Develop effective relationships with stakeholders at all levels of the organisationincluding 3rd parties and service providers.

Engage in effective communication and

Establish relationships with team members and assist colleagues where necessary

Work as part of a team to provide effective service delivery to an assigned area

Requirements

Matric

Basic / Post Basic Pharmacist Assistant qualification.

Any additional clinical knowledge will be beneficial

At least 5 years of experience in a managed care environment dealing with clinical issues would be an advantage

Previous experience in working and influencing client behaviour would be a great advantage