Case Manager Oncology Jobs Vacancy at Metropolitan Life in Bloemfontein

Job Title: Case Manager Oncology: DRM (Reference # 9278) Metropolitan Health Job Band:6

Introduction

This position will report to the DRM: Team Leader and is based in Braamfontein. The successful candidate will be required to manage clinical risk of oncology patients through the authorisation of clinically appropriate treatment and outbound interventions and will also be responsible for providing cost effective medical care, support and empowerment to patients to ensure a good quality of life across all Disease Management Programmes.

The Incumbent will be responsible for:

Liaising with patients, providers and Oncology Disease Management companies
Answering all queries related to Oncology management
Following up decisions with Providers and/or 3rd parties
Assisting with Oncology Pre-Authorisation
Monitoring the progress of patients on the Oncology programme
Maintaining relationships with 3rd parties
Assisting with early detection programmes
Facilitating reports to 3rd parties and the schemes
Initiating outbound contact with patients and providers where appropriate
Identifying and developing Clinical Guidelines
Authorising appropriate and cost effective medical care and treatment
Participating in the identification of clinical guidelines
Researching, designing and developing material relevant to promoting awareness of health promotions
Identifying all compliance risks
Educating and guiding all members regarding health care and their benefits
Supporting budget control and cost containment of health management programmes
Assisting with registration on various programmes to ensure quality of life for patients with life threatening diseases
Dealing promptly with client requests in a competent, efficient and professional manner
Liaising with specialists to gain their insight into assessing risks
Communicating with providers to improve the cost efficiencies of health care delivery

The applicant should meet these requirements:

Registered Nurse or Enrolled Nurse qualification or other clinical qualification with experience in private Oncology management
Minimum of 4 years clinical industry experience, preference will be given to candidates with Oncology management experience
Good understanding of the medical aid industry i.e. trends, competitors, legislation
Previous experience in a Managed Care environment an advantage
Afrikaans as a first language preferable
Fully computer literate

Competencies Required

Telephone etiquette & Communication – verbal and written
Creative and innovative
Document writing & Information gathering
Problem solving & Planning Skills
Time management
Willingness to learn
Relationship Building & People skills
Confidentiality & Accountability
Self-starter
Quality conscious
Responsibility and ownership
Organization and Attention to Detail Empathy
Customer & Results Orientation
Business Administration Skills
Teamwork and Cooperation
Industry Related Knowledge (Healthcare)

Additional Information

Shortlisted candidates will be subject to the following statutory checks:
ITC
Criminal
Reference
Qualification



How to apply

Internal applicants:

Sign on to PeopleSoft > Recruiting Activities > Careers

External applicants:

Go to our website

www.mhg.co.za

> Careers at Metropolitan Health> Vacancies

Assistance with online applications:

PeopleSoft Helpdesk (021) 940 5169

Contact Person:

Thembeka Mqanto

Telephone:

0123044507

Closing Date:

31 December 2012

Please state clearly for which position you are applying as well as the reference number in all communications. The job grade and remuneration will be commensurate with the successful applicant's experience, qualification and skills.

All MMI Employees must submit their CV's on People Soft.

Contact Details

First preference will be given to candidates registered with the Redeployment Centre for this vacancy.

Kindly forward your updated CV to redeployment@mhg.co.za and indicate the reference number and name of the position on the email subject line