Specialist: Disease and Programme Management
Our client, a managed care organisation based in Pretoria, is looking for a Specialist: Disease and Programme Management. This is an equal opportunity organisation with various businesses and/or subsidiaries that service clients in the medical scheme and insurance industries.
Purpose of the position:
The Specialist Disease and Programme Management will render active disease management, care support, coaching, and health education services to medical scheme beneficiaries who are registered for, and live with one or more of the Chronic Disease List (CDL) conditions by integrating the clinical care and self-management aspects. He/She will be an integral part of the clinical and disease management teams and will coach beneficiaries on how to achieve and sustain health outcome goals with a reduction in 'health years'.
Duties & Responsibilities
- Integrates skills and knowledge of pathophysiology, epidemiology, clinical management, conditions, and self-management of chronic conditions into clinical practice.
- Advocates for and communicates about improved quality of care and outcomes for those living with, are at risk for, or affected by chronic conditions.
- Performs comprehensive assessments for each patient including emotional and behavioural health.
- Interprets personal health data, develops an individualised care plan based on the patient’s assessed needs and goals, and promotes successful self-management.
- Facilitates follow-up and review of relevant pathology and other disease monitoring tests and interventions by engagement with the patient and/or treating service provider subject to the registered care plan or upon request.
- Documents all individual contacts and outcomes data in accordance with the guidelines in a timely manner.
- Identifies partially controlled patients and intervenes appropriately by liaising with the treating provider to manage the patients at risk.
- Participates in meetings and gives assistance to clinical, disease management, and member counselor team members with hospital admissions and patient outreach efforts as appropriate.
- Prepares reports/case studies as required.
- Performs other duties as assigned within the Managed Healthcare environment.
Desired Experience & Qualification
- Registered Nurse (additional post graduate certificate or diploma in counselling and/or psychology will be advantageous)
- Valid up to date SANC registration
- A minimum of 3 years’ experience in Disease Management, clinical patient management, and health education within a Managed Care environment.
- Oncology case management experience will be advantageous.
- Maternity wellness program experience will be advantageous.
- Dispensing license for nurse practitioners with a focus on the treatment of non-communicable diseases (NCDs) will be advantageous.
Package & Remuneration
Market related CTC package, based on experience, that includes medical scheme and provident fund (The structure of the package will be discussed at interview level based on the candidates’ qualifications and years of experience).
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