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Team Leader Hospital Risk Management
Job Location:
Job Location:
Port Elizabeth - South Africa
Monthly Salary:
Not provided by the employer
Monthly Salary:
Posted:
15 July 2026 (30+ days ago)
Posted:
Application Deadline:
12 October 2026
Application Deadline:
Vacancies:
1 Vacancy
Vacancies:
Job Summary
Our client in the Financial Services and Insurance industry is seeking to employ a Team Leader: Hospital Risk Management to join their team based in Port Elizabeth.
Purpose of Role:
To lead and support clinical teams in achieving operational and quality performance targets to enhance member health and claims outcomes.Requirements:
- Grade 12 / Matric is relevant
- General Nursing Diploma or Degree
- Must be registered with SANC (South African Nursing Council) as a Registered / Professional Nurse
- A minimum of 3 years experience in a managed care/case management environment
- A minimum of 3 years clinical experience within a private hospital is essential (ICU and theatre experience is advantageous)
- Prior leadership experience is advantageous
- Clinical Auditing experience is advantageous
- Good understanding of the Medical Scheme industry
- Proficient in Microsoft Office
Responsibilities:
- Lead and supervise the Case Management and Clinical Claims Auditing teams ensuring achievement of key performance indicators (KPIs) and service delivery
standards. - Ensure compliance with all company HR policies and procedures.
- Provide ongoing training guidance and communication to staff regarding benefits tariffs scheme rules and organisational policies and procedures.
- Support the resolution of complex and escalated case management and clinical audit queries.
- Manage and investigate complaints received from the Council for Medical Schemes (CMS) and liaise with Fund Managers to ensure effective resolution.
- Monitor analyse and report on weekly operational and performance metrics implementing corrective actions and continuous improvement initiatives where required.
- Assist Fund Managers with the compilation of information and preparation of reports and presentations for meetings and stakeholder engagements.
- Review and analyse workflow processes to identify efficiencies enhance productivity and ensure process relevance and effectiveness.
- Ensure all operational audit and performance reports are reviewed validated and appropriately actioned within agreed timelines.
Required Experience:
Manager
About Company
Headhunters is the Eastern Cape’s premier, boutique style recruitment agency. Whether you’re an employer, looking for that perfect person for your team, or that person, looking for the perfect job to ignite your passion. South Africa and beyond
