Billing Operations Cluster BOC Manager

We provide meaningful careers that connect people with purpose.

We are united by a common purpose of providing the best and safest care; and by our shared values of Care, Truth, Participation, Compassion and Dignity.

Netcare invites you to be part of our journey.

ROLE SUMMARY

The BOC manager is responsible to oversee full operations including finance, operational processes, and HR management of the Billing Operations Cluster. The BOC manager is seen to be a self-sufficient person able to take leadership, act autonomously and be a valued business partner, through the provision of proactive, innovative, and actionable insights, whilst displaying passion in providing business decision support for all managers and staff in the BOC. The incumbent should lead and initiate the development and implementation of best practices and tools consistent with the group strategy to be digitally enabled and data driven. The role is responsible for KPIs, CSAs, reporting, governance, compliance, and risk management.

KEY WORK OUTPUT AND ACCOUNTABILITIES
DISRUPTIVE INNOVATION
General Tasks
• Driver of new initiatives; a motivator of change for system enhancements and optimisation.
• Provide value-adding financial insights for development and implementation of operational strategies.
• Project manage and define clear priorities in multi-project environments.
• Manage high level medical aid escalation.
• Effective management of departmental reports.
• Develop communication channel to each of the sites’ hospital exco’s.
Build and maintain stakeholder relationships
• Work effectively and co-operatively with others to establish and maintain good working relationships that are mutually beneficial.
• Create and maintain a positive environment where the differences of others are recognized, understood, and valued, so that all can reach their full potential and maximize their contributions.
• Develop internal and external collaborative relationships to help accomplish work goals.
• Work closely with the senior teams in pharmacy, MHC and debtors for strategic initiatives
Clinical management and billing errors
• Monitoring and improvement of KPI’s.
• Set departmental targets and drive their outputs.
• Analyse workflow errors and address with appropriate action plans.
• Implement recommendations by Manage Health Care Quality Control Department.
• Effective Co-ordination of DNYB, PIP, Rejections and E-queries/Debt pack
Change Management
• Implement changes effectively and ensure compliance.
• Facilitate uptake of new billing digital tools.
• Ensuring LOGs are up to date.
Governance and quality management
• Identify quality improvement opportunities and ensure appropriate strategy and Quality Improvement initiatives are developed and measured.

TRANSFORMATION F OUR SOCIETY
Transformation target achievement
• Drive the achievement of transformation goals as set out by the Transformation Committee.
• Actively involved in the recruitment process.

Healthcare Knowledge
• Keeping abreast of changes that affect the local business environment.
• Keep up to date with administrator/medical aids rules and requirements.
• Keep updated with new developments in the managed health care industry and the health care industry.
People management
• Overall management of the billings team and performance thereof.
• Implement strategic plans, objectives and budgets through effective recruiting, training, motivation & evaluation of staff.
• Orientation of new staff to BOC environment.
• Develop talented leaders and high performers.
• Manage and assess staff performance.
• Assign decision making authority and task responsibility appropriately to maximize organization and employee effectiveness.
• Facilitate effective change & conflict management.
Teamwork
• Create an environment where staff are aware of the role they play in the provision of quality care and their value to the organization.
Personal and professional development
• Assume responsibility for own personal and professional development.
• Keep up to date with Netcare’s evolving policies and procedures.

SKILLS PROFILE
EDUCATION
Required
• B Degree/Diploma Nursing qualification or equivalent NQF level 6.

Preferred
• Qualified Registered Nurse

WORK EXPERIENCE
Required
• Managing a Managed Health Care or Billings department for > 4 years.

KNOWLEDGE
Required
• Sound knowledge of the Case Management, File Assessing and Confirmation functions.
• Sound knowledge of the Hospital Billings and Tariff guides.
• Experience in managing large teams.

PHYSICAL REQUIREMENTS

In the event of any physical or psychological limitation that may impair the employee’s ability to perform the required job function, the employee must consult the employer for reasonable accommodation.
VALUES AND BEHAVIOURS
Netcare Values
At Netcare, our core value is care. We care about the dignity of our patients and all members of the Netcare family. We care about the participation of our people and our partners in everything we do. We care about truth in all our actions. We are compassionate about quality care and professional excellence.
• Care - The basis of our business. The professional, ethical patient care and services we offer at every level of the organisation.
• Truth - The crucial element in building relationships that work. Open communication with honesty and integrity is essential.
• Dignity- An acknowledgement of the uniqueness of individuals. A commitment to care with the qualities of respect and understanding.
• Compassion - The creative, compassionate, and innovative drive to do things better than before. To develop and implement successful healthcare solutions for all.
• Participation - The willingness and desire to work in productive and creative partnerships with others and the commitment to communicate.

The Netcare Way
Netcare is committed to providing quality care. Our basic service standard holds us accountable for the below seven behaviours which you will be accountable to uphold:
• I always greet everyone to show my respect.
• I always wear my name badge to show my identity.
• I always treat others with consideration and humility to uphold dignity
• I always act in the best interest of Netcare and others to show I care.
• I always listen with empathy and respond with kind action to show my compassion
• I always say thank you to show my appreciation.
• I always embrace diversity to strengthen inclusivity and belonging.

SKILLS
Coaching Others
The capacity to recognise development areas in others and support them to facilitate personal development through coaching.
Leading and Managing Change
The capacity to implement and support change initiatives and to provide leadership in times of uncertainty.
Performance Development
The ability to evaluate and develop different levels of capacity within a team to achieve set objectives.
Taking Action
Capable of recognising the need for action, considering possible risks, and taking responsibility for results.
Decision Making
Capable of making decisions timeously and taking responsibility for the consequences.
Managing Self
Capacity to plan, organise and control own work environment by setting appropriate priorities and achieving set objectives within a given time frame.
Customer Focus and Service Delivery
The capacity to identify and respond to the needs of internal and external customers.
Adapting and Responding to Change
Capable of supporting and advocating change initiatives and managing own reaction to change.
Continuous Improvement
The capacity to improve systems and processes to facilitate continuous improvement.
Technical Knowledge
The capacity to perform a technical function to required standards.

WORKING CONDITIONS
• Professional flexibility in working hours while supporting daily business operations.
• Will interact with internal and external customers through several different means.
• Travel to support the functions of the role may be required.

Join the team committed to providing the best and safest health and care.