Jobs at Discovery Limited

Managing the risk relating to In hospital admissions, through the application of clinical and coding knowledge, protocols, legislation, standard operating procedures (SOP’s), service level agreements (SLA’s) and the member’s benefit structure. The role will apply to working in various settings, predominantly casualty. It is anticipated that the risk purpose will also extend into the general ward and high care/ICU settings as needed.

Coordinating the care of certain patients who are vulnerable to care gaps during transitions particular entry into hospital through to the emergency room, and discharge from hospital. The populations most vulnerable to gaps in care during transitions include clinically high risk patients; patients undergoing major surgical procedures; and patients with low socio-economic circumstances.

Please note: The successful applicants will be based at a designated hospital within the applicable region.

Principal Accountabilities

The successful applicant will be responsible for but not limited to the following job functions:

Assessing The Case In Relation To The Following

• Members clinical history
• Members benefit structure
• Clinical Information and coding supplied
• Level of care provided
• Appropriateness of the facility
• Appropriateness of the treating doctor
• Appropriateness of treatment
• Managing the benefit for the member and the risk for the relevant scheme through approving or declining treatment to ensure that the member gets the appropriate level of care
• Discharge planning by providing the member with alternatives to receive treatment
• Effective and accurate communication to all stakeholders
• Case update to the provider
• Funding decisions and Benefit confirmations to the members
• Request for additional information from the treating doctor
• Systems teams (issues experienced)
• Handling escalations from Providers and internal stakeholders
• Preparing and presenting complex case to clinical review
• Trend Analysis of inefficiencies and proposals to correct
• Appropriate internal case referrals for clinical management

Operational Targets

• Attend to patients on daily report
• Quality of processes
• Onsite perception survey

Personal Attributes

• Composure - Is cool under pressure; does not become defensive or irritated when times are tough; is considered mature; can be counted on to hold things together during tough times; can handle stress; is not knocked off balance by the unexpected; doesn't show frustration when resisted or blocked; is a settling influence in a crisis.
• Conflict Management - Steps up to conflicts, seeing them as opportunities; reads situations quickly; good at focused listening; can hammer out tough agreements and settle disputes equitably; can find common ground and get cooperation with minimum noise.
• Decision Quality – Makes good decisions (without considering how much time it takes) based upon a mixture of analysis, wisdom, experience, and judgment; most of his/her solutions and suggestions turn out to be correct and accurate when judged over time; sought out by others for advice and solutions.
• Integrity and Trust - Is widely trusted; is seen as a direct, truthful individual; can present the unvarnished truth in an appropriate and helpful manner; keeps confidences; admits mistakes; doesn't misrepresent him/herself for personal gain.
• Negotiating - Can negotiate skillfully in tough situations with both internal and external groups; can settle differences with minimum noise; can win concessions without damaging relationships; can be both direct and forceful as well as diplomatic; gains trust quickly of other parties to the negotiations; has a good sense of timing.
• Perseverance - Pursues everything with energy, drive, and a need to finish; seldom gives up before finishing, especially in the face of resistance or setbacks.
• Problem Solving - Uses rigorous logic and methods to solve difficult problems with effective solutions; probes all fruitful sources for answers; can see hidden problems; is excellent at honest analysis; looks beyond the obvious and doesn't stop at the first answers.

The Following Requirements Are Essential

Education and Experience:

• Matric
• Must be a Registered Nurse
• Valid SANC Registration
• 3 years Clinical experience in a private hospital setting (ICU, Trauma/Casualty, Medical/General ward preferable)
• 2 years Managed health care experience
• Microsoft Office (Specifically Excel experience)
• Valid Driver’s License and own transport
• Effective Communication Skills (Verbal & Written)
• Telephone Etiquette
• Active Listening Skills

The Following Requirements Will Be Advantageous

• 1 – 2 years ICU experience
• Knowledge of DH SOP’s and Process experience (internal only)
• Provider payment arrangements (internal Only)
• Clinical coding knowledge of ICD-10 and/or CCSA

go to method of application »

Grow and maintain a portfolio of intermediaries/franchises and ensure profitable new and existing business production through the establishment and management of strong intermediary relationships and service excellence in Insure Commercial Insurance.

Areas Of Responsibility May Include But Not Limited To

• Relationship management – develop and manage strong relationships with Intermediaries and internal staff
• Facilitate the on-boarding new intermediaries and training requirements around product, system and processes
• New business acquisition – grow and retain existing business based on agreed targets
• Provide quotations to intermediaries based on the company’s risk philosophy and procedures
• Industry participation – represent Discovery Insure on all Industry platforms and keep abreast with market trends and competitor information
• Risk management – Evaluate quotations, endorsements and renewals to determine whether to accept, decline or cancel risks based on underwriting criteria
• Manage risk acceptance within re-insurance and survey risk requirements and conduct regular policy screening actions
• Portfolio management – prepare and disseminate monthly portfolio reports, including portfolio drivers (conversion rates, loss ratios, lapses, policy growth, etc.) to all stakeholders
• Management of support service staff
• Assist with premium collection, policy reconciliation, bordereaux allocations and binder audits when required
• Prepare and present presentations to demonstrate Discovery Insurer’s value proposition to intermediaries/franchises

Personal Attributes and Skills

• Analytical
• Decision making / Independent thinking
• Presentation skills
• Microsoft Office
• Communication skills (verbal and written)
• Sales and Marketing

Education and Experience

• Matric is essential
• FAIS – Minimum credits as required (Personal Lines and Commercial) is essential
• RE 5 (Representative) is essential
• Short term insurance qualification (IISA designation) is Advantageous
• A relevant tertiary qualification is Advantageous
• Successful candidates who have not completed an IISA designated qualification need to complete this within an agreed time frame
• 5 years underwriting experience in Personal and Commercial Short Term Insurance is essential
• 3 years’ experience in Management of an Intermediary portfolio within Personal and Commercial Short Term Insurance environment is essential
• 10 years proven track record of managing and growing a profitable intermediary portfolio is advantageous

go to method of application »

Managing the risk relating to In hospital admissions, through the application of clinical and coding knowledge, protocols, legislation, standard operating procedures (SOP’s), service level agreements (SLA’s) and the member’s benefit structure. The role will apply to working in various settings, predominantly casualty. It is anticipated that the risk purpose will also extend into the general ward and high care/ICU settings as needed.

Coordinating the care of certain patients who are vulnerable to care gaps during transitions particular entry into hospital through to the emergency room, and discharge from hospital. The populations most vulnerable to gaps in care during transitions include clinically high risk patients; patients undergoing major surgical procedures; and patients with low socio-economic circumstances.

Please note: The successful applicants will be based at a designated hospital within the applicable region.

Principal Accountabilities

The successful applicant will be responsible for but not limited to the following job functions:

Assessing The Case In Relation To The Following

• Members clinical history
• Members benefit structure
• Clinical Information and coding supplied
• Level of care provided
• Appropriateness of the facility
• Appropriateness of the treating doctor
• Appropriateness of treatment
• Managing the benefit for the member and the risk for the relevant scheme through approving or declining treatment to ensure that the member gets the appropriate level of care
• Discharge planning by providing the member with alternatives to receive treatment
• Effective and accurate communication to all stakeholders
• Case update to the provider
• Funding decisions and Benefit confirmations to the members
• Request for additional information from the treating doctor
• Systems teams (issues experienced)
• Handling escalations from Providers and internal stakeholders
• Preparing and presenting complex case to clinical review
• Trend Analysis of inefficiencies and proposals to correct
• Appropriate internal case referrals for clinical management

Operational Targets

• Attend to patients on daily report
• Quality of processes
• Onsite perception survey

Personal Attributes

• Composure - Is cool under pressure; does not become defensive or irritated when times are tough; is considered mature; can be counted on to hold things together during tough times; can handle stress; is not knocked off balance by the unexpected; doesn't show frustration when resisted or blocked; is a settling influence in a crisis.
• Conflict Management - Steps up to conflicts, seeing them as opportunities; reads situations quickly; good at focused listening; can hammer out tough agreements and settle disputes equitably; can find common ground and get cooperation with minimum noise.
• Decision Quality – Makes good decisions (without considering how much time it takes) based upon a mixture of analysis, wisdom, experience, and judgment; most of his/her solutions and suggestions turn out to be correct and accurate when judged over time; sought out by others for advice and solutions.
• Integrity and Trust - Is widely trusted; is seen as a direct, truthful individual; can present the unvarnished truth in an appropriate and helpful manner; keeps confidences; admits mistakes; doesn't misrepresent him/herself for personal gain.
• Negotiating - Can negotiate skillfully in tough situations with both internal and external groups; can settle differences with minimum noise; can win concessions without damaging relationships; can be both direct and forceful as well as diplomatic; gains trust quickly of other parties to the negotiations; has a good sense of timing.
• Perseverance - Pursues everything with energy, drive, and a need to finish; seldom gives up before finishing, especially in the face of resistance or setbacks.
• Problem Solving - Uses rigorous logic and methods to solve difficult problems with effective solutions; probes all fruitful sources for answers; can see hidden problems; is excellent at honest analysis; looks beyond the obvious and doesn't stop at the first answers.

The Following Requirements Are Essential

Education and Experience:

• Matric
• Must be a Registered Nurse
• Valid SANC Registration
• 3 years Clinical experience in a private hospital setting (ICU, Trauma/Casualty, Medical/General ward preferable)
• 2 years Managed health care experience
• Microsoft Office (Specifically Excel experience)
• Valid Driver’s License and own transport
• Effective Communication Skills (Verbal & Written)
• Telephone Etiquette
• Active Listening Skills

The Following Requirements Will Be Advantageous

• 1 – 2 years ICU experience
• Knowledge of DH SOP’s and Process experience (internal only)
• Provider payment arrangements (internal Only)
• Clinical coding knowledge of ICD-10 and/or CCSA

go to method of application »

To create brand and communication solutions that enable business to meet their objectives by:

• Driving and defining the implementation of brand and communication strategy and solutions.
• Interfacing with senior business people to define and co-ordinate brand or communication strategy.
• Understanding the impact of that strategy across business.

Areas of responsibility may include but not limited to

• Unpack complex business needs and to provide creative solutions considering all stakeholders
• To create integrated solutions which are consistent across all brands/ businesses and communities and which meet best practice principles
• To ensure that solutions are in line with Discovery marketing model
• Develop people through coaching (as required)
• Manage a budget
• Build and maintain relationships with key business people, both at a strategic and operational level
• Proactive
• Bringing ideas to business
• Doing feasibility studies and defining new ways of doing things
• Measure impact and drive corrective action
• Ensure effective implementation of plans
• Manage conflict
• Reactive
• Responding to business needs

Competencies

• Knowledge
• Different Discovery audiences
• Various media channels, including electronic
• Discovery’s products and business processes
• Key individuals in Discovery and who to go to for what
• Print and production processes (including time lines and costing)
• Skill
• Convert technical information to audience appropriate communication
• Influence and persuade people to get things done
• Negotiate
• Present and sell your ideas
• Question processes, strategy and outputs
• Multi-task on multiple projects Leadership skills: Guide, develop and motivate others
• Make decisions
• Solve complex problems
• Build trusted partnerships
• Manage conflict
• Manage trade offs
• Instill confidence in others
• Communicate well in English both in writing and verbally
• Attributes
• Empathetic
• Diplomatic
• People and relationship focused
• Sociable
• Team player
• Seen as a trusted advisor by clients
• Resilient
• Able to work calmly under pressure and provide answers and direction to others
• Flexible and adaptable
• Tenacious and persistent
• Dynamic and energetic
• Driven
• Confident
• Passionate
• Have initiative- being a self-starter
• Naturally inclined to work hard
• Action oriented (doer)
• Solution oriented
• Detail oriented
• Ability to think outside the box

Education And Experience

• Qualifications
• Minimum 3 year undergraduate
• Post graduate qualification in marketing is preferable
• Relevant industry qualification
• Minimum of 5 years’ experience in Marketing or Communication
• Relevant industry experience, experience in Corporate Wellness, Employer or Business to Business healthcare marketing is preferable