Senior Healthcare Consultant

SUMMARY:
The Role:

The role of the Senior healthcare Consultant is to manage, service and retain a portfolio of large clients who have scheme and benefits arrangements that are underpinned by multi-disciplined architecture and design. Some client portfolios are complex with respect to the maintenance of policies and procedures vis-a-vis the delivery of ...

POSITION INFO:
The Role:

The role of the Senior healthcare Consultant is to manage, service and retain a portfolio of large clients who have scheme and benefits arrangements that are underpinned by multi-disciplined architecture and design. Some client portfolios are complex with respect to the maintenance of policies and procedures vis-a-vis the delivery of varied technical and professional advisory services.

Essential function:

• Being the primary point of contact for clients.
• Being responsible for client retention of a large and complex portfolio of clients.
• Building relationships with service providers to ensure training and claims/query processes are attended to accordingly.
• Providing accurate advice and Implementing and streamlining medical aid and gap cover processes within the client''s business with the assistance of the clientâ??s in rules in accordance with FAIS requirements.
• Dealing with escalations and queries such as CIB, Ex-gratia, and PMB; following dispute resolution through escalated channels. 
• Plan, Co-ordinate and conduct Wellness events with client Medical Scheme. 
• Ensure accurate record keeping on client communication, industry changes, newsletters, correspondence documentation, record of advice given. 
• Provide Medical Aid Quotations as well as Scheme Reviews Comparisons â?? on benchmarking sustainability models.
• Year End Revision, negotiate communicate open underwriting periods, launches, scheme highlights, YER planning, roll out and co-ordination.
• Managing ongoing relationships between clients and service providers, implementation of new service initiatives
• Understanding and maintaining a good working knowledge of the rules and compliance procedures of the industry, FSB and Council for Medical Schemes and implementing regulatory frameworks
• Implementing new service initiatives and streamlining processes with the assistance of the clientâ??s HR personnel, to maximise the efficiencies of information access.
• Being responsible to ensure that all service level agreements and appointment letters are signed and current and in place as well as ensuring that all administrative and regulatory matters relating to each client portfolio is up-to-date and in order.
• Being responsible for developing healthcare related educational programs conducting healthcare related training and conducting induction training and personalised one and ones. 
• Being responsible for relevant reports and information and data to all internal and external stakeholders, including executive reports. (ability to write own reports including power point presentations)
• Being responsible for quarterly reports to clients.
• Performing benchmarking and benefit richness reviews
• Managing year end renewal process.
• Being responsible for assisting more junior colleagues were applicable.

Essential Qualification:

• RE5, 120 FAIS CREDITS
• An NQF 5 or equivalent qualification in healthcare/healthcare administration 
• Accreditation on 8 medical schemes, 3 Gap cover schemes and 3 occupational health products is required.

Preferred Qualification:

• A relevant bachelorâ??s degree from a reputable tertiary educational institution would be advantageous.
• CFP
• Registration as a representative with the FSCA in terms of the FAIS act and CMS.

Experience required:

• Function related experience: < 10+> years - At least 8 to 10 yearsâ?? experience in a similar or related role.
• Extensive healthcare experience.
• A proven record of achievement as a consultant
• A well-developed knowledge of principles and practices within a technical/professional discipline.
• The ability to analyse data from medical schemes and competently and objectively present the findings to clients.
• The ability to assist senior colleagues in respect of the wellness strategy of clients.
• A good knowledge of policy wordings.
• Has working knowledge and experience in own discipline.
• Continues to build knowledge of the organization, processes and customers.
• Performs a range of mainly straightforward assignments.
• Uses prescribed guidelines or policies to analyse and resolve problems.
• Receives a moderate level of guidance and direction

Travel:

As and when required

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