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Team Leader and Training Coordinator - Hospital Risk Management
Fusion PersonnelJohannesburg, South Africa17 days ago
Job descriptionStrong knowledge of ICD-10, CPT-4 coding, PMB legislation, tariffs, and scheme rules. Ability to identify non-chargeable and overcharged items in hospital accounts. Knowledge of adult learning principles and training methodologies (advantageous). Team Leadership : Mentor and support staff, oversee workloads and SLA compliance, ensure quality standards, and deliver performance reports. Training Coordination : Design and deliver training programmes, conduct assessments, identify development needs, and align content with regulatory / industry changes. Clinical Governance & Systems : Handle complex clinical queries, ensure compliance in reconciliations, support data analysis and cost containment, and participate in system testing. Process Improvement & Communication : Update SOPs and processes, drive operational efficiency, maintain stakeholder relationships, and contribute to strategic initiatives.
Education & Experience :
- Nursing qualification (Diploma / Degree) with SANC registration (essential).
- Experience in pre-authorisation, case management, and clinical auditing within a managed healthcare / medical scheme environment (essential).
- Technical proficiency in managed healthcare systems, case management modules, and claims processing.
- Previous training, coaching, or mentoring experience.
- Supervisory / leadership background in clinical risk management (advantageous).
Knowledge & Skills :
Key Responsibilities
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Team Leader • Johannesburg, South Africa
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