Role PurposeTo manage clinical risk of patients through the authorisation of clinically appropriate treatment and outbound interventions.RequirementsMatric - essential Nursing Diploma or Degree - essential Minimum of 4 years clinical experience (including 2 years Oncology experience)- essential Registered with SANC- essential Experience in managed health care would be advantageous Duties and ResponsibilitiesLiaising with patients, providers and Disease Management companies Answering and assisting with all queries related to disease management programmes (Oncology and other chronic conditions) Following up on decisions with Providers and/or 3rd parties Maintaining relationships with 3rd parties Monitoring the progress of patience on disease management programmes. Assisting with early detection programmes and advocating available preventative health benefits to better manage risk Facilitating reports to the scheme Initiating outbound contact with patients and providers where appropriate Educating and guiding all members regarding health care and their benefits Authorizing appropriate and cost-effective medical care and treatment Applying set Clinical Guidelines and policies Possible identification of clinical guidelines. Identifying all compliance risks. Supporting budget control and cost containment of health management programmes. Assisting with registration on various programmes to ensure quality of life for patients with life threatening diseases Dealing promptly with client requests in a competent, efficient and professional manner. Liaising with specialists to gain insight into assessing risks. - #J-18808-Ljbffr