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. They 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
Key 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 or who are at risk for or affected by chronic conditions.
- Performs comprehensive assessments for each patient including emotional and behavioral health.
- Interprets personal health data, develops an individualized 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.
Core Competencies: - Comprehensive knowledge, skills, and experience in chronic disease management and patient health education and monitoring.
- Patient-centric.
- Excellent telephonic and written communication capability.
- Excellent listening skills and an ability to relate to people.
- Sensitivity and empathy.
- Ability to cope with emotional situations.
- Good organisational and task prioritisation skills.
- High degree of accuracy and attention to detail.
- Excellent report writing skills – case studies of high-risk and/or high-cost cases must detail outcomes.
- Must be able to work with a diverse patient population and have exceptional customer service skills.
- Proficient with MS Office (Outlook, Word, Excel) (knowledge and understanding of medical scheme administration and/or managed care information systems will be advantageous).
- Must be able to function within a team.
- The ability to speak more than two of the national languages will be advantageous.
Required Qualifications: - 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.
Candidates that meet the criteria may submit their applications via this portal or via the vacancy link on Should you receive no feedback within 7 days, please accept your application as unsuccessful.
- HR Services, Recruitment & Selection
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