Team Leader & Training Coordinator

Minimum Education:Nursing Qualification (Nursing Diploma as a registered nurse)Minimum Experience:3 to 5 years (previous pre-authorisation, case management experience in a managed healthcare environment isessential)Duties and Requirements includes but is not limited to the following:Knowledgeable of the Medical Schemes Act and Government Gazette on tariffsConduct telephonic assessment, competency assessments and first line interviews during recruitmentResponsible for the training of all new staff recruits in the areas of clinical assessing/auditing, pre-authorisation and specialised case managementProviding detailed training feedback post probationResponsible for identifying and meeting training needs of existing staffResponsible for identifying and updating system and process enhancements throughout the departmentReview and update training manuals, guidelines, standard operating procedures (SOPs) and cheat sheetsMaintain quality control for Clinical auditing staff and provide monthly feedback and stats to senior managerMonitor workload to ensure SLAs are metInvolvement with any complex hospital/ associated account queries leading to resolution and reconciliation of the accountAssist with all HR issues ie: performance counselling, change management etc.System testing:Responsible for testing any system programming changes that affect the departmentIdentify staff members who display an aptitude for testing and develop their testing abilitiesData Mining:Involvement with the data mining process from a statistical point of view within the areas of trends, costs and disease management, amongst othersReview of data for the Annual statutory return of the scheme to Council for Medical schemes