Job Description

Introduction

Momentum Health, an entity of Momentum Goup 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.

Disclaimer

As an applicant, please verify the legitimacy of this job advert on our company career page.

Role Purpose

To maintain client portfolio's through relationships and business retention.

Requirements

Tertiary qualification in clinical/medical field an advantage.
4 year experience in the Medical Scheme Administration industry.
Code 8 drivers licence and own vehicle.
Experience interacting at a senior level with / in companies an advantage

Duties & Responsibilities

Front-line external consultation with service providers.
Responsible for problem solving at all levels.
Written and verbal communication at a professional level with individual service providers.
One-on-one problem solving sessions on-site.
Build and maintain good relationships with doctors.
Queries and problems resolved accurately and timeously.
The year-end process runs smoothly and is facilitated to ensure that doctors are fully aware of all changes and options available to them.
Daily visits to service providers that are contracted to our scheme/s members.
Ensure coverage and frequency targets attained on all providers.
Draw and analyse practice profile statistics and other utilization reports.
Conduct risk discussion with cost inefficient drs that have been identified to be risk managed.
Consistently monitor cost effectiveness of all providers and have relevant discussions when & where necessary.
Enable and reach a financial savings target per year.
Train doctors and staff on scheme protocols and requirements.
Drive compliance at provider level.
Negotiate with and contract service providers onto provider networks.
Maintain a good understating of areas in order to assist with contracting decisions.
Bring feedback from the field back to the business.
Handle conflict situations at service provider level independently.
Plan work visit schedule and execute independently.
Escalate client queries to the relevant department or stakeholder.
Provide accurate information and advice to doctors and stakeholders.
Provide regular reports and keep accurate notes about interactions with providers according to overall department targets.
Provide authoritative, expertise and advice to doctors and stakeholders.
Build and maintain relationships with doctors (external) stakeholders.
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.
Constantly strive to improve service delivery to contracted providers.
Develop and maintain productive and collaborative working relationships with peers and stakeholders.
Positively influence and participate in change initiatives.
Represent MMI and act as ambassadors for the company in all/daily external interactions.
Continuously develop own expertise in terms of professional and industry knowledge.
Contribute to continuous innovation through the development, sharing and implementation of new ideas.
Identify opportunities to enhance cost effectiveness and increase operational efficiency.
Manage financial and other company resources under your control with due respect.

Competencies

Business Acumen.
Client/ Stakeholder Commitment.
Drive for Results.
Collaboration.
Impact and Influence.
* Self-Awareness and Insight