Large Managed Care organisation seek to employ a Quality Assessor to manage the assessment of the clinical and non-clinical interactions of their Case Managers and measure the level of service provided to members and service providers. Reports to the Service Manager.
Key Responsibilities:
- Identify and report on trends and training needs for HRM Case Managers and administration assistants
- Identify and report on the effectiveness of workflow systems to Department Managers to ensure system enhancements for improved service quality are initiated
- Weekly and monthly reporting on assessment scores
- Regular internal communication with Programme Managers, Team Leaders and Case Managers – feedback sessions wrt assessment and quality checks completed
- Coaching of Case Managers
Key Requirements:
- Registered Nurse currently registered with SANC
- At least 1 year in Quality Management within a Managed Care environment
- At least 4 years Managed Care experience with a minimum of 2 years in HRM Case Management
- High PC Literacy and working knowledge of call centre applications
- Excellent understanding of scheme administration and operational processes within HRM and DRM (Oncology, Maternity, Lifestyle)
- Advanced Excel ability and Oracle Administration System experience
To apply submit application to [Email Address Removed].
Supporting documentation required:
- Copy of Matric Certificate
- Copy of Nursing Degree
- Copy of current Registration with relevant industry body (SANC)
- Comprehensive CV detailing your QA HRM/ DRM experience
Desired Skills:
- At least 4 years Managed Care experience with a minimum of 2 years in HRM Case Management
Desired Work Experience:
- 2 to 5 years
Desired Qualification Level & Accreditations:
- Diploma
- South African Nursing Council