Disability Claims Consultant (Medical Qualification Required) at Sanlam Group

What will you do?

Manages selected patients that are likely to benefit from the case management process from admission until the account has been checked. Deals with a particular portfolio of cases, handling the larger more complex cases based on region and speciality. Liaises with the attending medical staff where necessary. Effectively authorises member admission based on intensity of services required to meet the patient's severity of illness, including updates to authorisation details for the appropriate facility and of the optimal period required in each unit. May train other Case Managers.

What will make you successful in this role?

Qualification And Experience

• Degree or Diploma with 6 to 8 years related experience

Knowledge And Skills

• Analyses, assessment and management of clinical outcomes and risk
• Management of scheme service level agreements
• Best practice clinical processes and management
• Coaching and mentoring others on case management
• Compliance and risk management

Personal Attributes

• Balances stakeholders - Contributing independently
• Manages complexity - Contributing independently
• Optimises work processes - Contributing independently
• Plans and aligns - Contributing independently

Build a successful career with us

Core Competencies

• Being resilient - Contributing independently
• Collaborates - Contributing independently
• Cultivates innovation - Contributing independently
• Customer focus - Contributing independently
• Drives engagement - Contributing independently