Clinical Care Team Leader

We are looking for an experienced Clinical Care Team Leader to lead a team of clinical professionals responsible for managing clinical and financial risk for high-risk beneficiaries. This role plays a critical part in promoting health-seeking behaviour, supporting beneficiaries, and coordinating care with family practitioners and key stakeholders. Reporting to the Clinical Care Manager, the successful candidate will provide strong operational leadership while ensuring compliance, quality delivery, and continuous improvement across the clinical care function.

• Registered Nurse with a 3- or 4-year medical qualification
• 5-8 years' experience in: Managed care & Health risk management
• Clinical customer service within the Medical Scheme Administration industry or similar
• Previous experience managing a clinical team will be advantageous

• Analyse and produce client-specific and business reports
• Ensure legal, statutory, and regulatory compliance within the team
• Implement and monitor operational risk and governance frameworks
• Manage departmental expenses and identify cost-saving opportunities
• Support the department in achieving financial targets

• Ensure high-quality work delivery aligned to agreed standards
• Implement and maintain Standard Operating Procedures
• Investigate and escalate IT-related operational issues
• Drive process improvements across internal operations and supply chains
• Resolve operational conflicts and ensure delivery targets are met
• Plan and implement daily, weekly, and quarterly operational changes
• Execute relevant business plan initiatives in line with departmental priorities
• Communicate operational plans clearly to ensure employee buy-in
• Drive continuous improvement and operational best practice

• Manage team performance in line with HR frameworks and policies
• Coach, mentor, and develop staff to build a skilled and engaged team
• Support transformation and value diversity
• Lead in alignment with company values

• Build and maintain strong relationships with customers and stakeholders
• Manage customer and stakeholder complaints in line with policy
• Strong ownership and decision-making ability
• High credibility, integrity, and transparency
• Ability to influence and collaborate across teams
• Sound knowledge of healthcare legislation, processes, and procedures
• Clinical risk assessment expertise
• Strong communication and business writing skills
• Analytical ability, numerical skills, and attention to detail
• Customer-focused with excellent problem-solving skills
• Proven ability to manage team and individual performance

• Make a meaningful impact on high-risk beneficiaries' health outcomes
• Lead a skilled clinical team in a purpose-driven environment
• Be part of an organisation that values integrity, collaboration, and continuous improvement

Note: Company reserves the right to close the advert before specified closing date.

PHA has its head office in Westville, KwaZulu-Natal. It operates country-wide with a nationally linked network and uses a robust, flexible, as well as integrated system to ensure efficient and effective administration of membership and benefits.