Clinical Consultant x6 – Momentum Health Solutions

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Clinical Consultant x6 – Momentum Health Solutions
Location: Centurion, Gauteng
Reference Number: MMH240902-4
Position Type: Permanent
Closing Date: 18 February 2025

Role Purpose

To ensure best practices in providing medical care and treatment while managing scheme benefits effectively.

Minimum Requirements

  • Matric (Senior Certificate)
  • Registered Nurse qualification (essential)
  • 2-3 years' experience in the managed care industry
  • Strong understanding of scheme products, legislation, and PMB guidelines
  • Telephonic etiquette and customer service skills

Key Responsibilities

  • Handle 70+ calls daily (240-second handling time per call)
  • Maintain high-quality customer service
  • Ensure turnaround time of 48 hours for bin management
  • Implement policies and protocols related to scheme benefits
  • Control in-hospital and out-of-hospital benefits
  • Apply exclusions correctly and consistently
  • Build and maintain strong relationships with hospitals and providers
  • Refer cases appropriately to case management teams

Key Competencies

  • Strong business acumen and understanding of risks
  • Client-focused approach with long-lasting relationship management
  • High sense of urgency, accountability, and execution skills
  • Ability to drive continuous improvement through innovation
  • Strong influencing and communication skills
  • Resilience in handling pressure and ambiguity
  • Cultural awareness and openness to diverse backgrounds

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