Position: Team Leader: Care Operations
Department: Bonitas Hospital Management Services
Grade: B3M2 Position
Purpose: To lead a team of professional staff to ensure the management of financial and clinical risks through the application of scheme rules and clinical policies and procedures.
Experience: 5 years Managed Healthcare and 2 years case management experience 1 – 2 years supervisory experience and 2years ICU experience advantageous
Qualifications: Relevant Clinical Qualification, Registration with the relevant statutory bodies Professional Membership
Generic Objectives Specific deliverables:
People Leadership:
-Lead and inspire your people and drive team collaboration.
-Develop and support your people growth by focusing on their strengths and styles.
-Coach and enable team to maximize their potential.
-Empower your people with skills to improve confidence, knowledge and communication skills.
-Amplify your people’s imagination and self -learning.
-Create a safe and happy working environment that inspires all, adapting to needs of your people.
-Manage, monitor leave and wellness of your people.
-Recognize and appreciate excellence and team collaboration in real -time. Continuous improvement:
-Identify areas of improvement and solving for sustainable solutions through root cause analysis, lean six sigma methodologies and feedback loops.
-Assist with user acceptance testing and coach your teams through changes.
-Demonstrate excellence in communication and daily performance management.
Workforce Management:
-Perform Resource planning, forecasting and management across all channels and touch points.
-Manage and plan downtime when required.
-Manage work volume and ensure service levels are met and improved. Business Continuity Management:
-Understand how to manage business continuity and unplanned downtime.
-Manage incidents and service level continuity. Manage and Maintain Operational Content:
-Represent the business capability in the organization's governance model.
-Collaborate with solution capabilities and product owners to ensure operational content enables the implementation of all business strategies.
-Manage and maintain consistency of all Standard Operating Processes and Operational Resources by working collaboratively with capability owners and forums.
-Attend and participate in all required forums in the governance model, supporting all roles in the business model. Manage Performance:
-Motivate the team to achieve the organizational goals.
-Manage timelines and priorities to ensure business goals are met.
-Conduct performance reviews and align to frequent coaching.
-Provide exceptional organization and focus for the team. Conduct performance management.
Position Specific Outputs Work Scheduling
-Resource planning and management
-Queue management Training and coaching
-Identify ongoing training and developmental gaps i.e. PDPs
-Refer training needs (TNA) to HCBP / central training/QA/ISO to address
-Reinforces on the job learning after central training has signed off. Does not provide basic training but does assist with up-skilling during probation period after HC Training BP has signed off
-Provide on the job coaching to address specific performance gaps (KPIs
-Performance improvement plans which will also include personal development plans (linked to Performance management) Administration and reporting -Ensure that SLAs are met
-Complete and submit operational reports including monthly ISO compliance template reports
-Do trend and root cause analysis and recommend improvements
-Do VOEs and take corrective actions -Ensure that escalation management is done by Senior Agent(s). Address limited number of escalations. Process stale claims as per the Scheme Rules.
-Implement Year end as per project plan -Facilitate originator, business or client focus group sessions on variety of topics i.e. problem-solving, communication, membership related issues Financial Management
-Control leave liability -Monitor and reduce wastage, identify cost saving opportunities i.e. staff, stationery & printing, telephones, processes Leadership -Performance management i.e. ongoing evaluation via own voice samples and quality assessment, ratings
