Specialised Healthcare Coach

About the role

The Specialised Healthcare Coach is responsible for managing the quality and cost of clinical and medical care by liaising with members and providers. The role focuses on improving health outcomes, reducing financial risk, and ensuring cost‑effective treatment for beneficiaries.

Key responsibilities

• Prioritise patient management tasks and plan daily activities for allocated members.
• Interact with patients, GPs, specialists, home‑based and convalescent nurses to coordinate care.
• Monitor and reduce recurring costly events and medicine spend.
• Educate beneficiaries about their diseases and support them in understanding their health status.
• Maintain detailed records of patient interactions and ensure timely documentation.
• Implement policies and guidelines to manage in‑patient and out‑patient episode costs.
• Authorize cost‑effective medical care, apply exclusions correctly, and follow acute case‑management protocols.
• Monitor service quality, resolve client queries, and provide regular performance reports.

Required profile

• Matric/Grade 12 qualification.
• Registered Nurse (diploma or degree) registered with the South African Nursing Council.
• Minimum three years of clinical practice in the relevant discipline.
• Experience in HIV/AIDS management, including education, counselling and care coordination.
• Additional experience in HRM, DRM, primary‑care nurse practitioner training, or managed‑care case management is advantageous.

Required skills

• HIV/AIDS management
• Case management
• Primary‑care nursing
• Healthcare cost management