Clinical Risk | Virtual Care Team Leader at Kaelo

Randburg, Gauteng, South Africa -

Full Time

Start Date

Immediate

Expiry Date

11 Jun, 26

Salary

0.0

Posted On

13 Mar, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Team Leadership, Operational Leadership, Quality Assurance, Staff Training, Service Improvement, Compliance, Service Level Agreement, Reporting, Clinical Triage, Escalation Management, Line Management, Scheduling, Risk Management, Health Risk Assessment, Computer Literacy, ICD Codes

Industry

Insurance

Description

Company Description About Kaelo Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change. Kaelo meets the Healthcare needs of Corporate and Retail clients across South Africa – products offerings include Medical Insurance, Medical Aid, Gap Insurance, Kaelo Money and employee assistance programmes. Job Description The Clinical Team Lead is responsible for the operational leadership of the designated virtual care team at Kaelo. The role oversees the virtual care practice activities to ensure delivery of high-quality, safe, and cost effective services. Candidates will be required to support staff training and development, service improvement, and compliance with relevant standards and policies. They will be expected to provide regular feedback on operational activities to their line manager and ensure service level agreement standards are met. In addition to leading the team, candidates are also expected to assist the clinical team with daily duties by interacting directly with clients using the virtual care service. This position reports to the Clinical manager. Note: This job specification provides a general outline of the responsibilities and qualifications expected of a Clinical Team Lead. Specific duties and requirements may vary depending on the organisation. Responsibilities include: Team Lead Specific Duties Develop and maintain reports of daily activities, present analysis and feedback to the Clinical manager. Perform monthly Quality Assurance Audits for the team. Allocate daily roles and activities to team members based on demand and capacity. Where applicable, ensure that the team are appropriately allocated to afterhours duties, and maintain a record of timesheets to be submitted to the line manager for remuneration of afterhours activities. Ensure the team is meeting their specified SLA for all daily activities, where inefficiencies or issues are noted these must be raised to the line manager immediately. Ensure GP authorisations are loaded accurately and completely according to company standards and policies. Training and coaching the team (including but not limited to: company policies and standards, product rules, clinical guidelines) to ensure high-quality clinical care management services are provided. Communicate with the Health Service Cantre Manager to ensure operational efficiencies between the Health Service Centre and virtual care teams. Provide input and support for projects as required by the business Daily operational activities Virtual care bookings Ensure that the team calendars are appropriately opened and/or blocked according to the tea, availability and scheduling Ensure that members are being consulted as scheduled Manage any escalations related to consultations Consulting patients together with the team during the available time slots Weekly reporting of bookings and consultations Clinical triage queue Ensure availability of a team daily who is responsible for the calls being transferred from the call centre Ensure the tracker is completed daily Ensure accurate call tagging Report on weekly summary or tracker Administrative duties Line management of virtual care nurse team 1:1 monthly Leave management Training and development Scheduling of Drs according to their availability Act as a liaison for the VC doctors Quality auditing Rostering and scheduling General Report any clinical escalations/concerns to the Clinical Review Committee or clinical risk management teams Maintain confidentiality in clinical conditions shared with her/him. Key outcomes Assist the Clinical and Medical Advisors to identify appropriate resources and guidelines to effectively assess, prioritize, advise, and manage patients presenting with a variety of primary healthcare conditions, including but not limited to: Common acute and chronic outpatient conditions, emergency conditions, HIV, maternity and family planning, child care. Ensure all team members thoroughly complete documentation utilizing the appropriate computer software in compliance with the approved policies and procedures. Ensure all team members maintain current nursing skills and knowledge base by attendance at workshops and seminars, completion of mandatory continued professional development, reading of professional journals, publications, and participation in professional organizations. Develop and maintain reports on the activities carried out within their team, presenting feedback and analysis of targets and outcomes. Qualifications EDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODY REQUIRED Professional Nurse / Registered Nurse / Enrolled Nurse / ALS paramedic Degree / Diploma in Nursing A minimum of 5 years nursing experience. Experience across both the public and private health sector. Medical Aid or Insurance industry experience will be an advantage. Knowledge of ICD codes. DESIRED PHC, Midwifery, and HIV experience is an advantage. TECHNICAL SKILLS OR KNOWLEDGE REQUIRED Strong understanding of clinical codes. Attention to detail. Health risk assessment knowledge. Computer Literacy (Microsoft office). Additional Information PERSONAL ATTRIBUTES: BEHAVIORAL COMPETENCIES Accountability for clinical decisions made. Communication with all related health care workers, patient, and next of kin involved in a case. Writing skills-for clear and concise notes that are easy to understand. Efficient and effective mindset to make clear clinical decisions without prejudice and interfering personal beliefs. Planning and organisation of work. Resilient and adaptive to different environments. Prioritizes patient care Self-development Ethical always maintaining professional image and language. Team player

Responsibilities

The Clinical Team Lead is responsible for the operational leadership of the designated virtual care team, ensuring high-quality, safe, and cost-effective service delivery through staff training, service improvement, and compliance monitoring. This role also requires assisting the clinical team with daily duties by directly interacting with clients using the virtual care service.