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Clinical Consultant

Che Leigh Personnel Consultants
12 days ago
Full-time
On-site
Alberton, South Africa
Consulting

Introduction

The purpose of this role is to provide comprehensive member-centric clinical management services aimed at improving health outcomes, coordinating appropriate care, reducing avoidable healthcare costs, and enhancing the overall quality of care provided to members of the Scheme.
The role is responsible for the proactive management of members with chronic diseases and high-risk health conditions, with a specific focus on Primary Health Care (PHC) services and chronic disease management including, but not limited to, Tuberculosis (TB), HIV/AIDS, Diabetes Mellitus, Hypertension, Asthma, Cardiovascular Disease and other identified chronic conditions.

Duties & Responsibilities

  • Manage allocated member cases through the full case management cycle.
  • Identify high-risk, high-cost, and chronic members requiring intervention.
  • Coordinate holistic healthcare interventions aimed at improving member outcomes.

Manage chronic disease programmes

  • Monitor member adherence to prescribed treatment plans.
  • Support and coordinate Primary Health Care initiatives within Scheme medical centres and service provider networks.
  • Promote utilization of appropriate PHC services as a cost-effective alternative to higher levels of care where clinically appropriate
  • Monitor hospital admissions, length of stay, and discharge planning where applicable.
  • Coordinate post-discharge follow-up and continuity of care.
  • Identify cases requiring clinical intervention or escalation
  • Engage providers regarding treatment plans, clinical motivation, and member management
  • Assist in resolving member and provider clinical queries.
  • Support multidisciplinary collaboration in member care management
  • Prepare reports and statistics.
  • Maintain accurate clinical and administrative documentation.
  • Maintain confidentiality of member clinical information.
  • Adhere to professional ethical standards and scope of practice requirements

Desired Experience & Qualification

Qualifications

  • Diploma or Degree in Nursing, Clinical Care, or relevant healthcare qualification.
  • Additional qualification in Case Management, Primary Health Care, HIV/TB Management, or Chronic Disease Management will be advantageous.
  • Current registration with the relevant professional council.

 

3.2. Experience

  • Minimum 3 – 5 years’ experience in:
    • Managed healthcare
    • Medical scheme environment
    • Primary Health Care
    • Chronic disease management
  • Experience managing HIV, TB, Diabetes, Hypertension, and other chronic conditions.

Interested?