We are looking for a Disease Management Counsellor.
The DM counsellor provides telephonic education, advice and support to contracted medical scheme/healthcare plan beneficiaries with specific chronic illnesses enrolled on the various Disease Risk Management Programmes. The counsellor also helps coordinate care where necessary for the enrolled beneficiaries. When required, the counsellor will conduct site visits to clients for HIV testing and/or Health check screening.
Conditions are but not limited to: Asthma, COPD, Hypertension, Diabetes Mellitus Type 1 and 2, Cardiac Failure, Coronary Artery Disease, Hyperlipidaemia, HIV.
Duties and Responsibilities:
HIV/AIDS and Chronic Disease Management
- Ensure that all telephone and call logging systems are logged into 5 minutes before the start of scheduled shift.
- Adhere to the staffing schedule which indicates start times, break times and end of daytimes.
- Answer all telephone calls from members, intermediaries and suppliers, as well as public and internal parties, and ensure that lost calls are limited to the required Service Level Agreements (SLA’s) of all Schemes.
- Ensure service excellence and customer satisfaction through, but not limited to:
- Understanding the caller's query and reason for their call
- Listening, acknowledging, and empathising with the caller
- Asking the correct and probing questions to fully understand the caller’s needs
- Research required information using available resources to ensure that the caller received complete and accurate answers to their queries
- Keeping caller up to date on progress relating to their queries that may have not been resolved on first contact
- Going the extra mile to ensure first time resolution of the caller's query
- Ensure that 99% of all calls are resolved first time
- Ensure that service level agreements for clients are consistently met with regards to call answer service level and disease management contacts.
- Maintain confidentiality about the patient. Keep all information disclosed to the counsellor confidential.
- Attend to incoming phone calls from new enrollees on the Disease Risk Management Programme.
- Phone the beneficiary according to a specified schedule and discuss their chronic conditions with the beneficiary.
- Verify eligibility of beneficiary on medical scheme or health plan according to beneficiary data files.
- Obtain supporting diagnostic information and confirm eligibility.
- Explain the benefits of the Disease Risk Management Programme to the beneficiary and the role of the Disease Risk Management Programme.
- Identify areas of the condition where the beneficiary requires education and support regarding their chronic diseases.
- Provide education about the nature of the chronic illness(es), triggers and complications that might aggravate their condition and lifestyle changes.
- Educate the beneficiary about the management of their condition in an emergency.
- Ensure that the beneficiary understands how to take their medicines and the need to remain adherent to their treatment.
- Obtain and follow up on relevant pathology reports on a regular basis, and results from the beneficiary or beneficiary’s doctor and update them on the Disease Management system.
- Capture on the Disease Management database, relevant information about the beneficiary and their chronic illnesses
- Set achievable goals and targets for the beneficiary to achieve i.e. lose a specified number of kilograms in a defined time period, reduce the cholesterol by a certain percentage etc.
- Provide relevant dietary and lifestyle advice. All advice is required to be correct and appropriate to the condition.
- Advise the beneficiary regarding standard cover for their conditions.
- Arrange and perform future follow up contact to counsel the beneficiary.
- Arrange for relevant educational material to be mailed to the beneficiary.
Required profile for job ad : Disease Management Counsellor - Windhoek
Experience and Qualifications requirements
- Nursing Diploma or Degree – equivalent to Enrolled or Professional Nurse
- Experience and knowledge of HIV/AIDS are advantages.
- Experience and knowledge of the following Chronic conditions is a requirement: Asthma, COPD, Diabetes, Cardiovascular and Hypothyroidism.
- Experience in counselling and knowledge of the managed care area are advantages.
- Experience and knowledge of the medical schemes legislation advantages.
Language requirements
- English: Primary business language. Be able to speak, write, spell, read and comprehend the language.
- Competency in any other ethic language and advantage.
Registration requirements
- Must have a valid registration with the applicable Health Professions Council of Namibia.
Computer literacy
- Proficiency with the following programs is required:
MS Word MS Excel
MS Outlook/ email MS Explorer/Internet
- Some prior knowledge /experience with medical scheme administration and/or managed care system.
Work requirements
- The company is based in Namibia, Windhoek.
- Own transport and valid driver’s license is essential.
- Willingness to travel and work longer hours when the business needs require the counsellor to do so is a requirement.
- Confidentiality of all patients’ clinical information and conditions to be maintained and respected.
- The employee may be required to sign a confidentiality agreement.
- Company intellectual property and systems not be disclosed to external agent or organization.
