Client Relationship Manager

Discovery Care

Client Relationship Manager In Hospital Case Management 

About Discovery

Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders, Discovery is passionate about innovating in order to not only achieve financial success, but to ignite positive and meaningful change within our society.

About Discovery Care

Discovery Care, a subsidiary of Discovery Health, comprises of several specialized clinical areas with segmented teams. The Chronic and PMB Management team handles the processing of Chronic and Prescribed Minimum Benefit requests and manages escalated clinical queries. The HIV/Oncology and In-Hospital Case Management teams review clinical cases specific to their areas of expertise. The High Touch team provides hands-on services and resolves escalated queries for sensitive cases. Additionally, the Hospital Benefit Specialists, as part of field force, are responsible for real-time risk management and the Care Coordination Services manages the Managed Care programs.

Please take note that this role is open to the below regions:

Gauteng, ECP, KZN

Key Purpose:

To accurately review and assess In Hospital related queries and updates, in line with Discovery Health products and in accordance with benefit entry criteria and established protocols

Key Outputs:

• The successful applicant will be responsible for but not limited to the following job functions:
• Dealing with all IH queries and escalations through to resolution
• Enforcing policy, protocol and benefits decisions
• Meeting daily Operational Targets, TWT, etc.
• Ad Hoc duties based on business requirements
• Communicating effectively and accurately, progress, outcomes to complainants verbally and in writing
• To liaise with relevant stakeholders involved in the member’s care to ensure the best possible member journey.

Skills:

• Adapts interpersonal style to suit different people or situations
• Adapts to changing circumstances
• Assertive and confident
• Attention to detail
• Customer focused
• Demonstrates integrity
• Shows urgency and passion for servicing

Competencies:

The successful candidate must demonstrate the following competencies:

Education and Experience:

The following requirements are essential:

• Matric
• Nursing Qualification (Enrolled/Professional Nurse)
• Valid SANC Registration
• Discovery Health working experience in a clinical role
• Discovery Health products and system knowledge
• PMB Legislation Knowledge
• Analytical Skills
• Effective Communication Skills (Written & Verbal)
• MS Office

The following requirements are advantageous:

• 1 year CRM Experience
• Discovery Health Pre-Authorizations working experience

Employment Equity  

The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply

EMPLOYMENT EQUITY   
                             
The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.