Clinical QA wanted in Durban.The role will be responsible for ensuring that the Disease Outcomes and Consolidated Treatment units, within the Bankmed Business Unit, achieve their quality objective on an ongoing basis.
Responsibilities and outputsAssessment of clinical and non-clinical interactions of Case Managers, to measure the level of service provided to members and service providers.
Identifying and reporting of trends and training needs with the focus on the development of Metropolitan Health Risk Management Case Managers and administration assistants.
Identifying and reporting problem areas pertaining to the effectiveness of workflow systems to Departmental Managers, to ensure system enhancements for improved service quality are initiated.
Develop best practice operating procedures to promote high-quality output of work.Compiling weekly and monthly reports on assessment scores as well as errors detected.
Communicating regularly with the Programme Managers, Team Leaders, and Case Managers, and conduct feedback sessions in terms of assessment and quality checks being doneLiaise 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.
Coaching of Case Managers and administration assistants to achieve desired quality levels.Facilitating training sessions as and when required.
Analyze member survey results and quality trends.Continuously stay abreast of developments in the business related to the Disease Outcomes and Consolidated Treatment units.
Matric / Grade 123 - 5 years call centre experience3 - 5 years managed health care experienceClinical Qualification (Registered Nursing sister / Registered Pharmacist)