Emergency Medical Case Manager
- Head Office, Illovo, Johannesburg.
- Emergency Medical Case Manager
A full time position exists for an Emergency Medical Case Manager at Life Employee Health Solutions (EHS), within the Life EMS Department, to be based at Life Healthcare’s Head Office, situated in Illovo, Johannesburg.
- Critical Outputs
- Conducting site and geographical location emergency response risk assessments.
- Developing and updating of Emergency Response Management Plans, Standard Operating Procedures, Operational Guidelines, etc.
- Appropriate resource allocation during emergency incidents, arranging ambulance (ground and / or air) transfers and receiving facilities, as required.
- Remotely monitor patient’s care during all stages of pre-hospital, in-hospital and out-of-hospital specialist treatment.
- Compiling and communicating clinical status reports and treatment plans to relevant stakeholders.
- Reviewing clinical information and making suggestions on appropriate treatment protocols in line with standard levels of care.
- Liaising between Clients, patients, on-site clinicians, in-hospital treating clinicians, external service providers and Employee Wellness Program providers on a case-by-case basis.
- Establish meaningful, long-lasting professional relationships between Life EHS / Life EMS, Clients, provider & Specialist networks, insurers, funders and medical aids.
- Record keeping, managing injury and illness databases, data analysis and provision of periodical reports.
- Working effectively within a budget and ensuring smooth administration of all aspects of the services.
- Meeting the prescribed professional and quality standards of Life Healthcare, Life EHS, Life EMS and Clients.
- Ensuring Client satisfaction through quality service delivery, continuous improvement and added value.
- Administratively strong and highly competent in the use of computers and different Microsoft Office programs.
- Assist with other administrative and operational duties, as may be required.
- Relevant medical qualification, with at least 2 years clinical work experience in an operational environment.
- Call centre experience of at least 2 years.
- Extensive knowledge and experience (> 5 years) in direct client engagement, client relations, service delivery, health and wellness products and understanding of contractual obligations.
- Extensive knowledge and experience in medical case management, including understanding and implementation of funder and insurer’s requirements, liaising with hospitals and Specialists, liaising with patients, in- and out-of-hospital authorisations, as well as medical claims management.
- Good understanding of international insurance benefits, authorisation processes, case management and an above average understanding of clinical coding systems / classification of diseases standards (ICD10 or similar) and experience in working with healthcare administration systems and digital healthcare technology.
- In-depth understanding of how healthcare provider and referral networks operate with the capability of negotiating preferential services and rates and setting up of such networks.
- Very good verbal and non-verbal communication skills with excellent interpersonal and liaison skills.
- Experience in training and facilitation would be beneficial.
- Proven track record and experience in customer complaints resolution.
- Experience in interpretation and reporting of statistical data.
- Good general understanding of legislation pertaining to healthcare, Emergency Medical Services, Compensation of Occupational Injuries and Diseases and Mine Health and Safety Act.
- Computer literacy in all recognized Microsoft Office packages essential.
- Be in good health and may be required to undergo a fitness to work medical examination, inclusive of a drug screening test and applicants may be required to have a criminal check done.
- Must have own, reliable transport with the ability and willingness to travel (average of 6 to 10 non-consecutive days per month).
- Ability and willingness to fulfil standby duties.
- Closing date
- Friday, May 24, 2019
Internal applicants - Before making an application, you are requested to discuss your application with your line manager. Only short listed candidates will be contacted. Should you not receive any communication after 2 weeks of closing date, kindly consider your application as unsuccessful.
External candidates will also be considered.
Explore our vacancies and find the right opportunity for you. Download the application form and email to the relevant contact person specified in the job advertisement.
Life Healthcare is an equal opportunity employer.
Add the following in the email subject line when applying: CM05/19_ your surname