Introduction
Through our client-facing brands, Momentum Group, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group. The group enables business and people from all walks of life to achieve their financial goals and life aspirations. We help people grow their savings, protect what matters to them and invest for the future. We help companies and organisations care for and reward their employees and members.
Disclaimer
As an applicant, please verify the legitimacy of this job advert on our company career page.
Role Purpose
This role offers exciting and challenging opportunities and is aimed at dynamic, performance orientated, knowledgeable and experienced staff members, who are able to deliver quality outputs in a highly deadline and client orientated environment. You will be required to work well within a team as well as on your own. Reporting to the QA Manager, the successful candidate will ensure that the Disease Outcomes and Consolidated Treatment units achieve their quality objectives on an ongoing basis.
Requirements
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National Senior Certificate (Matric)
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3 - 5 years call centre experience
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3 - 5 years Managed Healthcare experience
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Clinical Qualification (Registered or Enrolled Nurse)
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Supervisory/ Team Leader experience will be advantageous.
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Quality management experience will be advantageous.
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Computer literacy in MS Office as well as the call centre applications (inclusive of the assessment system)
Duties & Responsibilities
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Assessment of clinical and nonclinical interactions (i.e. calls,correspondence and captures) of Case Managers, to measure the level of service provided to members and service providers
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Identifying and reporting of trends and training needs with the focus on development of Momentum Health Risk Management Case Managers and administration assistants.
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Identifying and reporting of problem areas pertaining to the effectiveness of work flow systems to Departmental Managers
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To ensure system enhancements for improved service quality are initiated
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Develop best practice operating procedures to promote high quality output of work.
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Compiling weekly and monthly reports on assessment scores as well as errors detected.
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Communicating regularly with the Programme Managers, Team Leaders and Case Managers and conduct feedback sessions in terms of assessment and quality checks being done.
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Liaise with all relevant role players in the event of disputes regarding customer satisfaction measures in order to ensure the accurate and consistent application of procedures.
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Coaching of Case Managers and administration assistants to achieve desired quality levels.
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Facilitating training sessions when required.
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Analyse member survey results and quality trends.
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Continuously stay abreast of developments in the business related to the Disease Outcomes and Consolidated Treatment units.
Competencies
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Proven experience and understanding of scheme administration and the operational processes of the various Managed Care Programmes.
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Proven analytical ability.
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Excellent communication, listening and interpersonal skills.
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Ability to liaise professionally and courteously at all levels.
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Pro-activeness and drive.
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Good decision making skills.
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Assertiveness
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Ability to work independently.
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Ability to work under pressure.
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Ability to remain and act neutral/ impartial
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Ability to communicate recommendations in a constructive manner.
