HIV Case Manager

• Member retention and customer services
• Maintain risk profile of members enrolled on Disease Management Programmes
• Ensuring continuous improvement and process improvement
• Production of educational material and dissemination to patients
• Retrospective review of related claims
• Developing and maintaining clinical protocols including new drug reviews
• Working with other healthcare personnel within the organisation
• Liaising with pharmaceutical companies
• Compilation of monthly reports detailing programme progress and areas of cost containment
• Keep abreast of benefit changes
• Develop and deliver educational presentations to employer groups

• Excellent knowledge of Chronic Disease treatments and procedures
• Knowledge of Clinical Protocols
• Knowledge of Prescribed Minimum benefit protocols and algorithms would be an advantage
• Medical aid / managed healthcare experience is an advantage
• Experience in disease management is an advantage

Fusion Personnel