CARE TEAM NURSE

Responsibilities:

• Pre-authorization of scheduled and non-scheduled admissions to ensure validity, legitimacy of admission, and advice on cover
• Liaise with physicians to obtain client medical reports to ensure they are getting optimal, quality care at most
• Negotiate professional fees for each admission to ensure clients are receiving cost effective care within the scope of their cover
• Manage the 24-hour helpline and ensure client enquiries are sorted to satisfaction and assist with medical emergencies
• Visit all admitted clients as part of company PR and to ensure the clients are getting appropriate satisfactory services
• Attend to preauthorization email requests promptly
• Co-ordination of inter-hospital transfers, medical evacuation, step down care, home care and nursing, care upgrade as when required as per clinical assessment
• Audit existing providers to ensure that protocol is adhered to (if not adhered to, make recommendation on next action-suspend/terminate/warning.)
• Train providers on GA protocols to maintain standards
• Renegotiation of terms with existing Service Providers within set GA insurance guidelines; make recommendations for changing terms outside the job’s