Team Leader and Training Coordinator - Hospital Risk Management

Fusion Personnel; Johannesburg; On-site; ZAR 400,000 - 600,000; Full time

Job summary

A healthcare staffing organization seeks a qualified nursing professional to lead a team in a managed healthcare environment. Key responsibilities include mentored staff, designing training programs, and handling complex clinical queries. The ideal candidate must possess a nursing qualification with SANC registration and have experience in case management. This role offers opportunities for professional development and operational efficiency enhancement.

Qualifications

• Nursing qualification (Diploma/Degree) with SANC registration essential.
• Experience in pre-authorisation and case management is required.
• Supervisory experience in clinical risk management is advantageous.

Responsibilities

• Mentor and support staff while overseeing workloads.
• Design and deliver training programs in compliance with regulations.
• Handle complex clinical queries and support data analysis.
• Drive operational efficiency and maintain stakeholder relationships.

Skills

Clinical risk management

Mentoring

ICD-10 coding

CPT-4 coding

Education

Nursing qualification (Diploma / Degree) with SANC registration

Tools

Managed healthcare systems

Job description

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

• Strong 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).

Key Responsibilities

• 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.