Medscheme Clinical Risk Specialists in the spotlight
With 2024 being “The year of the Client”, service excellence, innovation and improving our stakeholder relationships are taking centre stage. Get to know more about the Medscheme Clinical Risk Specialists (CRS) who play a crucial role in the frontline of our open and closed medical scheme clients.
The Medscheme CRS team comprises skilled clinical professionals, including pharmacists, enrolled nurses and doctors, and reports to General Manager Sarah Bennett in Mike Marshall’s Care Research & Product development team.
All in a day’s work
Working very closely with clients, the CRS develops and supports strategic plans with respect to our Solution Capabilities (Disease Management, Wellness & Lifestyle, Oncology, Provider Management, Hospital Event Management, Healthcare Facilities, Product Development) where applicable for the client.
They understand the client’s strategic goals and communicate them to the strategic design units within Medscheme to further develop an internal strategy for the client. Regular Managed Health Care (MHC) or similar meetings focus on strategic issues and product development ensures clients are kept informed with relevant content.
The team continuously demonstrates Medscheme’s thought leadership through the Care strategy. They also provide relevant ad hoc information, including competitor analyses and external trends, to help our client schemes in strategic decision-making.
The CRS represents the client at internal forum meetings to identify solutions or products that support their strategy and highlight where additional products may require development, thereby playing a key role in benefit design.
Once a solution is implemented, the CRS team monitor the outcomes and presents multiple detailed reports, working collaboratively with the Functional Heads and Care product experts.
All CRSs play an important role in creating new business opportunities with client schemes, and this extends to the integration of products within the greater AfroCentric Group and Sanlam.
The CRS GEMS team up close
While Medscheme is responsible for the GEMS managed care contract, the administration contract is serviced by another service provider. The Medscheme CRS team for GEMS is structured to mimic the client’s GEMS Healthcare Management division. It includes several team members reporting to General Manager, Dr Ayanda Mbuli.
Clinical Risk Specialists and their clients
| CRS | Client |
|---|---|
| Shafeeka Modack | Bonitas Parmed |
| Catherine Gay Melanie Schenck | Fedhealth Horizon |
| Erick Calitz Liz Theron | AECI MBMed SAMWUMed |
| Celeste Behoor | SABC Medshield |
| Dr Mari Gildenhuys Mathabo Mohlatlole | Polmed Barloworld |
| Paseka Mokoena | GEMS |
| Wisahl Playton | Project Administrator |
