Job Description

Closing Date 2023/10/09
Reference Number MMH230908-3
Job Title Clinical Executive
Position Type Permanent
Role Family Medical
Cluster Health Solutions
Remote Opportunity None of the time
Location - Country South Africa
Location - Province Gauteng
Location - Town / City Centurion
Introduction

Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by using a defined set of Health capabilities.
Role Purpose

To work at the strategic interface between key clients, solution design and health risk management execution capabilities for the purpose of client-centric solution discovery, service management, risk management and relationship management. Incumbents will proactively serve as a xe2x80x9ctrusted advisorxe2x80x9d and function as a key point of contact for the client on all matters pertaining to health risk management and wellness solutions. They will provide valued consulting level support and guidance through an in-depth understanding of the clientxe2x80x99s needs, member health risk profiles, and key initiatives aimed at improving claims outcomes and reducing product and claims risk. They will also act as an advocate on behalf of clients and business stakeholders to ensure services meet business priorities, service level objectives and client needs.
Requirements

• Undergraduate degree in the field of health is a prerequisite E.g. MBCHB/ B Pharm/BCur (Registration with HPCSA or SANC)

• Post graduate diplomas in health management considered an advantage

• Post graduate management qualification considered an advantage

• 5 years working experience in a managed care environment in a senior operational, managerial, or strategic capacity (Extensive medical aid, healthcare management, and managed care knowledge)

• A proven track record in terms of the key competencies listed above

• At least two years of experience in a client facing role

Duties & Responsibilities

Enable client centricity within area of responsibility (Client)

• Build and maintain relationships with clients and internal and external stakeholders.

• Understand the client's workplace programmes and health issues and competitor activity as it relates to health and wellness solutions.

• Understand other relationships that the client has with external stakeholders in the health industry.

• Have a clear understanding of the clientxe2x80x99s strategy and be able to advise clients relevant to their strategy and on how MHS can effectively partner with the clients to realise their health and wellness goals in context of the Value Proposition.

• Provide authoritative, expertise and advice to clients and stakeholders. (Strong clinical support requirement.)

• Contribute to the process of negotiating objective and realistic service level agreements, monitor appropriateness and recommend adjustments.

• Drive client service delivery goal achievement in line with predefined standards to ensure that clients receive appropriate advice, service and that client expectations are managed.

• Present regular reports on delivery of services against agreed service level agreements and in terms of overall client targets.

• Provide executive summaries and forthcoming solutions in a concise and impactful manner.

• Manage client query processes and ensure that queries are tracked, accurately resolved and used as a mechanism to make recommendations to improve client service and fair treatment of clients within area of responsibility.

• Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service.

Effectively action responsibilities (Internal Process)

• Support and work closely with the Solution Design (Actuarial and Health Risk Management) Teams, to bring clinical and research insight as it relates to the emerging trends both locally and internationally.

• Work closely with the segment teams and provide health insight and support.

• Cooperating and assisting the execution and reporting teams to identify gaps as it relates to design and value reporting and suggest opportunities for improvement based on client feedback and emerging trends.

• Support the communication of the value of not only managed care services but any healthcare or wellness solution as provided by the reporting team.

Effectively lead team (People)

• Create a positive work climate and culture to give meaning to work, minimise work disruption and maximise employee productivity.

• Drive a culture that guides and directs best practice, fostering an environment of continuous learning, improvement and cohesiveness.

• Demonstrate exemplary leadership behaviour, through personal involvement, commitment and dedication in support of organisational values.

• Enable a learning and growth culture whereby information regarding successes, issues, trends and ideas are actively shared between team members.

• Encourage innovation, change agility and collaboration within the team.

Manage budget and implement sound financial controls (Finance)

• Contribute to the process of negotiating contract terms, rates and renewals.

• Manage high risk and problematic financial issues in area of accountability and contribute to the development of policy.

• Plan and implement a cycle of medium-term improvements to drive pricing of services and products.

Competencies

Strategic thinking

• Understands own business area, industry context and current competitive situation from which to develop strategic business questions for own area

Client/Stakeholder Commitment

• Anticipates, meets and exceeds clientxe2x80x99s needs by creating long lasting relationships that support the client value proposition, supports their financial wellness and ensures client centricity.

Drive for Results

• Drive a sense of urgency, focus, accountability, agility and execution to deliver business results.

Leads Change and Innovation

• Actively leads change, does what is right for the business and drives continuous improvement through innovation.

Collaboration

• Prioritises the business interests of MMH and invests in the success of the group by aligning effort across divisions.

Impact and Influence

• Persuades, convinces, influences and inspires others, both within MMH and externally to win support, loyalty and gain commitment to the purpose of MMH.

Self-Awareness and Insight

• Manages self and relationships with others effectively and provides perspective in difficult situations.

Diversity and Inclusiveness

• Is sensitive to individual and cultural similarities and differences and demonstrates humility and an openness to engage people from diverse backgrounds and cultures to the mutual benefit of all parties concerned.

Leads Change and Innovation

• Actively leads change, does what is right for the business and drives continuous improvement through innovation.

Policy

We are committed to Employment Equity, diversity and inclusion when recruiting internally and externally. All appointments are made in alignment to our Employment Equity goals and we encourage people with disabilities to apply.

Momentum Metropolitan