Wellness Coach: Health4Me
Financial Services, Insurance
Minimum Requirements
- Matric
- Nursing Diploma or Degree
- Enrolled Nurse or Registered Nurse is essential
- One year case management Experience in a managed care environment
- Three years clinical practice in the discipline
- in both hospital case management and/ or disease management (advantageous).
- Possess the applicable registration to the respective professional bodies as it is required by the medical schemes Act Regulation 15D (1) (d)
- Knowledge of Momentum Health Administration system (advantageous)
- High standards of personal integrity, honesty and respect for confidentiality and feedback to clients.
- Be sensitive to individual and cultural differences and demonstrates humility and an openness to engage people from diverse backgrounds and cultures to the mutual benefit of all parties concerned.
- Manages self and relationships with others effectively, deals with ambiguity, uncertainty and pressure, and provides perspective in difficult situations.
- Understands how the business operates, what the key issues and risks are that drives business success.
- Anticipates, meets and exceeds client's needs by creating long lasting relationships that support the client value proposition, supports their financial wellness and ensures client centricity
- Persuades, convinces, influences and inspires others, both within Momentum Group and externally to win support,loyalty and gain commitment to the purpose of Momentum Group.
- Drive a sense of urgency, focus, accountability, agility and execution to deliver business results.
- Prioritises the business interests of Momentum Group and invests in the success of the group by aligning effort across divisions.
- Actively leads change, does what is right for the business and drives continuous improvement through innovation.
- Presence and flexibility in the wellness coaching process.
- Prepared to take accountability for the relationship with the beneficiary.
- Sensitive and open-minded.
- Ability to express the patient roadmap clearly and succinctly.
- Analytical and able to identify and interact on relevant and important questions and aspects as are important to the beneficiary.
- High levels of responsibility and discernment about own role in the patient management cascade.
- Good level of clinical competencies.
- Synthesizing and analytical skilled relevant to the clinical Education of all role players.
- Manage cost of an in or out-patient episode by implementing appropriate policies and guidelines.
- Arrange post hospital care where necessary.
- Authorise appropriate and cost-effective medical care and treatment.
- Ensure the consistent and correct application of exclusions.
- Adhere to policies and procedures and take corrective action where necessary.
- Adhere to organisational best practice and legislative Duties & Responsibilities The aim of this position is to manage quality and cost of clinical and medical care by liaising with members and providers.
- Build strong relationships through providing specialist know-how and leadership to others, expressing positive expectations.
- Prioritise work in accordance with required intensity of patient and cost management.
- Daily planning and organisation in accordance with case load.
- Accountability for daily work load and required interventions.
- Interaction with member, GP and Specialist and other providers including home based and convalescent nurses.
- Manage quality and cost of clinical and medical care by liaising with medical providers, members and their families as well as other 3rd party service providers when need be.
- Work with individual consumers(beneficiaries and providers) of the Insurer to achieve better health outcomes while helping beneficiaries to understand their benefits, disease(s) or health status.
- Reduce the downstream clinical and financial risk associated with the beneficiary.
- Co-ordinate the required interactions between the various providers and hospitals
- 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.
- Continued Medical Responsibilities The aim of this position is to manage quality and cost of clinical and medical care by liaising with members and providers.
- Continued Medical
- in a managed care environment
- of all role players.
Responsibilities
- The aim of this position is to manage quality and cost of clinical and medical care by liaising with members and providers.
- Build strong relationships through providing specialist know-how and leadership to others, expressing positive expectations.
- Prioritise work in accordance with required intensity of patient and cost management.
- Daily planning and organisation in accordance with case load.
- Accountability for daily work load and required interventions.
- Interaction with member, GP and Specialist and other providers including home based and convalescent nurses.
- Manage quality and cost of clinical and medical care by liaising with medical providers, members and their families as well as other 3rd party service providers when need be.
- Work with individual consumers(beneficiaries and providers) of the Insurer to achieve better health outcomes while helping beneficiaries to understand their benefits, disease(s) or health status.
- Reduce the downstream clinical and financial risk associated with the beneficiary.
- Co-ordinate the required interactions between the various providers and hospitals
- 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.
- Continued Medical Responsibilities The aim of this position is to manage quality and cost of clinical and medical care by liaising with members and providers.
- Continued Medical
