Oncology Case Manager Talent Pool - Gauteng and KwaZulu Natal

Key Purpose: Management of enrolled Oncology members by reviewing clinical appropriateness of treatment as prescribed, ensuring correct application of Clinical Entry Criteria, Protocols, SOPs and Clinical guidelines, explaining the benefit to the member and providing counselling.

Responsibilities include:

• Enroll member on the Oncology Program and ensure all eligibility requirements are met.
• Review treatment plans in line with SAOC and Icon guidelines.
• Approve or decline treatment in line with SAOC/Icon and Discovery Health protocol.
• Refer complex cases to internal and external medical review teams and provide feedback to members and providers.
• Communicate funding decisions verbally or in writing.
• Document comprehensive notes on treatments and funding decisions.
• Use clinical knowledge to identify and report risks.
• Provide support to members, CHO Service Agents, doctors and pharmacists.
• Coordinate treatment plans and send updated guidelines to doctors.
• Meet daily operational targets.

The successful candidate must demonstrate the following competencies:

• Action oriented
• Business insight
• Cultivates innovation
• Interpersonal savvy
• Nimble learning
• Organizational savvy
• Plans and aligns
• Situational adaptability

Essential requirements:

• Matric
• Registered & Enrolled Nurse
• Registered with SANC
• 2 years clinical experience
• Knowledge of oncology treatment interventions
• Microsoft Office proficiency

Advantageous requirements:

• 1-year experience as a Case Manager
• Experience with DH systems and products

• Values driven
• Learns on the fly
• Resilient
• Instills trust
• People savvy
• Drives results

The Company's approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.