Clinical Client Relationship Manager-Fixed Term Contract

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.

NB: This role is open to all regions - Gauteng, Cape Town, Durban, Port Elizabeth

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
• Answering inbound calls timeously
• Meeting daily Operational Targets, TWT, Hunt line SLA 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 members 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

Behavioral Attributes

• Action Oriented - Enjoys working hard; is action oriented and full of energy for the things he/she sees as challenging; not fearful of acting with a minimum of planning; seizes more opportunities than others.
• Dealing with Ambiguity - Can effectively cope with change; can shift gears comfortably; can decide and act without having the total picture; isn't upset when things are up in the air; doesn't have to finish things before moving on; can comfortably handle risk and uncertainty.
• Integrity and Trust - Is widely trusted; is seen as a direct, truthful individual; can present the unvarnished truth in an appropriate and helpful manner; keeps confidences; admits mistakes; doesn't misrepresent him/herself for personal gain.
• Learning on the Fly - Learns quickly when facing new problems; a relentless and versatile learner; open to change; analyzes both successes and failures for clues to improvement; experiments and will try anything to find solutions; enjoys the challenge of unfamiliar tasks; quickly grasps the essence and the underlying structure of anything.
• Organizational Agility - Knowledgeable about how organizations work; knows how to get things done both through formal channels and the informal network; understands the origin and reasoning behind key policies, practices, and procedures; understands the cultures of organizations.
• Perseverance - Pursues everything with energy, drive, and a need to finish; seldom gives up before finishing, especially in the face of resistance or setbacks.
• Written Communications - Is able to write clearly and succinctly in a variety of communication settings and styles; can get messages across that have the desired effect.

Qualification & 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
• 3-6 months consistent on/above par performance

EMPLOYMENT EQUITY

The Companys 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.