Product Solution Specialist

We're looking for a candidate to fill this position in an exciting company.



Description

The person will also be involved in staff engagement with regards to Coaching, Qualitiy Assurance to achieve the strategy as per a solution/product implementation. The position reports directly to the HOD: Clinical Risk Management.

Operational:
Monitoring of SLA with a focus on outcomes measurements and drivers of poor performance and providing solutions
Meet with other Departments monthly to identify challenges and find technical solutions. Implementation of solutions in accordance with project timelines
Managing the DRM process with regards to non-compliance reports, multiple admissions and weekly hospital admissions reports and finding solutions to automate outputs into workflow
Assist with Audit investigations
Attend to operational challenges and find solutions
Work instructions - Review current and update accordingly
Product/Project/Strategies:



Project management and implementation of all strategies within the Department
Investigate best methods in executing of Departmental and Company strategy from a technical point of view with regular feedback to Head of Department
Product development: Prioritising, Managing, overseeing development stages, anticipating client needs, acting as primary liaison, evaluating product progress and feedback
Creation of new work instructions
Automation of reports - provide spec for Departmental automation of reports and execution thereof
Engage with IT on system requirements and follow-up on development thereof
Handling of queries and escalations within Department and find solutions to prevent recurrent queries especially claims queries
Attend to Smoke survey escalations daily - ensure Private banking experience and equip consultants with tools to improve
Assist with QA of team members where required and find better processes for quality to measure the correct outcomes
Assisting in Departmental Culture survey feedback, action plan and implementation thereof

Requirements



Grade 12.
A Clinical Degree.
Project Management experience is essential
Previous exposure in a Managed Healthcare environment is essential.
Sound knowledge of the Coding Systems: ICD10 & CPT4 Principles and sound knowledge of the Medical Aid Industry, Rules & Regulations, ISO and other related legislation is essential.
Holistic Patient Management would be advantageous.
Coaching experience would be advantageous.
Excellent business writing & communication skills.
Must have strong organisational awareness to anticipate the impact of actions on other groups.
Effective conflict resolution skills and the ability to work under pressure.
Must be a strong team player and results driven.
Computer literacy (MS Office and Medical Administration system).