Sorayah Davids
Cape Town,South Africa
Summary
Accomplished professional with extensive expertise in health systems strengthening,programme implementation and senior stakeholder engagement. Demonstrates a strong track record in capacity building, community outreach planning, and multi-sectoral collaboration. Proficient in programme delivery and project management,Committed to advancing healthcare initiatives through effective donor reporting and strategic programme execution.Strong focus on enhancing health information systems and electronic medical records.. Skilled in case management, medical billing/administration, and managed healthcare systems.
Overview
39
39
years of professional experience
10
10
years of post-secondary education
Work history
Independent Contractor – Program Support
Anova Health Institute
2026.03 - 2026.04
- Supported implementation of My Journey Programme
- Implemented Rapid Testing Continuous Quality Improvement Programme
- Capacity building of Health and Wellness Counsellors
- Ensured all relevant SOPS , policies and guidelines are in place, orientation of staff on SOPS and guidelines
- Develop internal asset/stock requisition system
- Ensuring mobile vans are equipped with all necessary supplies , and safety practices
- Set up of medicine room, including stock management systems
- Supported preparation for clinical compliance assessment
- Stakeholder engagement with sub structures
- Coaching and mentoring Clinical Manager
HTS(HIV Testing Services) Manager
Anova Health Institute
2019.06 - 2025.02
- Oversee implementation of HIV Testing Services programme at facility, community and district level in line with SAG 95-95-95 strategies and as per agreed funder work plan.
- Led roll out of all HIV testing modalities implementation at facilities and community level in cluster.
- Led roll out of Rapid Testing Continuous Quality Improvement programme in cluster.
- Led community outreach, health promotion, advocacy and campaigns for priority populations (Adolescents and Young People and Men)
- Supported roll out and implementation of Men's Health programme in cluster, provided technical support to Coach Impilo's
- Develop tools and system to ensure effective referral and linkage to appropriate services for priority populations
- Provided leadership and oversight to 41 staff in cluster.
- Develop training plans, arrange external training as required
- Manage all HR related functions for direct line including timesheets and leave.
- Support HR with recruitment and selection, labour/employee relations matters.
- Provided technical assistance and strategic guidance to Metro Health Services/Provincial Office/City Health and other NPO counterparts.
- Capacity building of own teams, other streams in cluster as well other NPO/CBO staff.
- Organize, facilitate and support district, sub district and facility based stakeholder engagements promoting integration and linkages to support Metro Health Services/City Health with programme implementation.
- Organize and support multi sectoral engagements and collaborations, civil society, higher health and other community based organizations.
- Leveraging networks to expand service offerings to communities.(Linkage to ART , PrEP and family planning , referral for psychosocial services and VMMC)
- Provided oversight on track and trace activities , recalling, adherence and retention support
- Close collaboration with M & E team on all programme related activities, data accuracy and clean ups.
- Manage, support and assist with all aspects of monitoring and evaluation related to HTS program activities, data collection, data validation and reporting
- Used data dashboards to track program performance for adaptive management.
- Prepared quarterly progress for USAID reporting, lead USAID 1st 95 oversight visits in USAID to cluster and supported Clinical Lab Interface and other oversight visits in cluster
- Developed daily workload, weekly and monthly tracking and reporting tools.
- Compile and submit monthly and quarterly reports to programme manager.
Assistant Programme Manager
Kheth'Impilo
2019.03 - 2019.05
- Provided programme support to City Health HAST Unit
Technical Specialist QA
BroadReach Healthcare
2010.10 - 2018.11
- Provide technical assistance to health establishments across 7 supported districts on implementation of national quality standards.
- Develop process improvement solutions and make recommendations to stakeholders/management(DOH).
- Obtain external stakeholder buy-in to proposed solutions at appropriate level.
- Deliver facilitative training/workshops to district/sub district and operational staff.
- Collaborate with districts to set up required district/sub district structures to ensure accountability and sustainability of quality improvement initiatives.
- Provide technical assistance to National Dept. of Health - QA-Directorate.
- Provide technical assistance to Office of Health Standards and Compliance with development, piloting and implementation of national health quality indicators and early warning systems.
- Supported development of guidelines and revision of guidelines.
- Provide technical support to internal teams to implement strategies to meet 90-90-90 strategies targets as per agreed funder work plan.
- Supported implementation of key components of ICSM to impact HAST Performance - process mapping and 3 stream implementation at facilities.
- Used data dashboards to track program performance, provide feedback and recommendations to district teams.
- Compile and submit monthly and quarterly reports and contribute to quarterly funder reports.
- Support district teams during funder oversight visits and assessments.
Case Manager(Locum)
Panorama Medi-Clinic
2010.06 - 2010.09
- Managing of patient's progress from admission to discharge on daily basis by doing ward rounds and updating patients clinical information
- Monitor patient admissions and identify those who have limitations, restrictions, place by their managed care/ medical aid structures e.g. length of stay
- Liaising with medical aid schemes daily, updating on patient's general progress, level of care, length of stay and any changes to patient's diagnoses and procedures and clinical information
- Ensuring correct ICD 10 and CPT 4 codes are updated with medical aids
- Update all information timeous and accurately
- Audit and release all final billed accounts for system re pricing and electronic submission to medical aid schemes
- Audit and correct all electronic account rejections from medical aid schemes
- Liaise with patients and medical aid schemes
- Resolve patient and medical aid scheme queries
- Liaised effectively with other professionals such as doctors, nurses and therapists in order to provide coordinated service delivery.
Deployment Lead
Hospiserve Healthcare
2009.08 - 2010.03
- Proactively communicate and collaborate with (clients) stakeholders to analyze current business and system needs and functional requirements through site assessments.
- Obtain client commitment to the reviewed processes both at a senior management and supervisory level.
- Assist and guide the client to document their processes, business and operation needs and develop gap analysis.
- Develop business processes in terms of unique customer requirements and requirements of the Hospiserve Health Information Management System (HIMS).
- Document the client's system aligned business processes and manage client sign off on business processes
- Develop the necessary business process training material.
- Schedule and implement business process training (workshops) for key client personnel and management.
- Establish processes and metrics to monitor and manage integrity of business processes post implementation
- Schedule, plan and conduct post implementation audits as per agreed service level agreement (SLA
- Support the Project Manager & activities throughout the go-live period to successful implementation and handover to the Service Desk team.
- Support the post go-live activities during the agreed post go-live period
Consultant – +Healthcare Consulting - Dubai (UAE) (Freelance) Quality Improvement Coordinator - Clinical Services
Al Noor Hospital Group
2007.12 - 2009.02
- Evaluate and document program findings to improve patient care, clinical performance and care delivery systems.
- Identify risk management opportunities.
- Prioritize and investigate risk occurrences, perform root cause analysis investigations and make recommendations regarding system and policy changes.
- Monitor compliance to International Standards (JCIA) and Health Authority Regulations in clinical and non-clinical areas.
- Coordination and planning of activities in preparation for accreditation and certification bodies - ISO Re Certification, Joint Commission International Accreditation (JCIA), Health Authority Abu Dhabi(HAAD) inspections National Insurer Evaluation for Abu Dhabi emirate(Daman).
- Ongoing training and mentorship of hospital staff
- Oversee daily operations of the Quality Department including budgeting and human resources.
- Responsible for own performance as well as performance of staff allocated to Quality Department.
- Support implementation of electronic medical record system and 3M Coding system.
- Support medical staff with any system related issues
Case Manager(Locum)
Cape Town Medi-Clinic
2007.02 - 2007.07
- Managing of patient's progress from admission to discharge on daily basis by doing ward rounds and updating patients clinical information
- Monitor patient admissions and identify those who have limitations, restrictions, place by their managed care/ medical aid structures e.g. length of
- Liaising with medical aid schemes daily, updating on patient's general progress, level of care, length of stay and any changes to patient's diagnoses and procedures and clinical information
- Ensuring correct ICD 10 and CPT 4 codes are updated with Health Care Funders
- Update all information timeous and accurately
- Audit and release all final billed accounts for system re pricing and electronic submission to medical aid schemes
- Audit and correct all electronic account rejections from medical aid schemes
- Liaise with patients and medical aid schemes
- Resolve patient and medical aid scheme queries
- Locum
Supervisor - Utilization Care Review
Saad Specialist Hospital
2004.06 - 2006.06
- Supervise and support utilization review (UR) / case management staff
- Allocate workloads and ensure timely completion of utilization reviews
- Review complex, high-risk, or escalated cases (e.g. extended LOS, denials)
- Ensure appropriate level of care decisions (inpatient, outpatient, step-down)
- Monitor length of stay (LOS), readmissions, and medical necessity
- Conduct quality audits of utilization review documentation
- Identify trends in over- or under-utilization and recommend corrective actions
- Liaise with medical insurers on approvals , rejections and appeals
- Ensure approvals obtained for all selective and emergency admissions
- Ensure adherence to regulatory, accreditation, and payer requirements
- Maintain compliance with hospital policies, ethical standards, and patient rights
- Support accreditation and internal/external audits
- Ensure proper documentation for authorizations and appeals
- Communicate authorization outcomes, rejections and appeals
- Analyse utilization data and prepare management reports
- Track trends in admissions, LOS, denials, and cost containment
- Lead utilization improvement initiatives and process optimization
Case Manager
Kingsbury Hospital
2001.06 - 2004.04
- Managing of patient's progress from admission to discharge on daily basis by doing ward rounds and updating patients clinical information
- Monitor patient admissions and identify those who have limitations, restrictions, place by their managed care/ medical aid structures e.g. length of
- Liaising with medical aid schemes daily, updating on patient's general progress, level of care, length of stay and any changes to patient's diagnoses and procedures and clinical information
- Ensuring correct ICD 10 and CPT 4 codes are updated with Health Care Funders
- Update all information timeous and accurately
- Audit and release all final billed accounts for system re pricing and electronic submission to medical aid schemes
- Audit and correct all electronic account rejections from medical aid schemes
- Liaise with patients and medical aid schemes
- Resolve patient and medical aid scheme queries
Hospital Authorisations
Metropolitan Health
1995.07 - 2001.05
- Request, obtain, and confirm pre-authorisations from medical schemes/insurers
- Verify patient benefits, limits, and level of cover before admission or procedures
- Ensure correct ICD-10 and CPT/procedure codes are used for authorisations
- Follow up on pending, delayed, or declined authorisations
- Confirm authorisation prior to elective admissions and procedures
- Liaise with hospitals, doctors' rooms, and theatres regarding admission status
- Assist emergency admissions with retrospective authorisations where applicable
Claims Assessor
Bankmed Medical Aid
1987.02 - 2001.04
- Assess and process medical aid claims accurately according to scheme rules, policies, and tariff guidelines
- Verify member eligibility, benefits, and authorization requirements before approving claims
- Review hospital, specialist, pharmacy, and healthcare provider accounts for correctness and compliance
- Identify incorrect coding, duplicate claims, fraud, waste, or abuse and escalate where necessary
- Interpret ICD-10, CPT, and tariff codes to ensure accurate claim adjudication
- Liaise with healthcare providers, members, and internal departments regarding claim queries and discrepancies
- Ensure claims are processed within turnaround times and service level agreements (SLAs)
- Capture and update claim information on medical aid administration systems
- Investigate rejected or suspended claims and provide feedback or recommendations
- Maintain confidentiality and compliance with healthcare regulations and medical scheme policies
- Assist with audits, reporting, and quality assurance processes
- Support pre-authorisation and case management teams where required
- Provide professional customer service to members and service providers
- Keep updated on changes in medical aid rules, coding standards, and healthcare legislation
- Prepare reports on claims trends, exceptions, and high-cost case
Education
Short course - Healthcare Risk Management
Health Authority Abu Dhabi
Abu DhabiShort Course - Integrated HIV/TB Management
Kheth'Impilo
Senior Certificate -
Lyceum College
1979.01 - 1983.12
Diploma - General Nursing
Carinus Nursing College
1983.01 - 1986.12
Higher National Certificate - Total Quality Management
University of South Africa
2010.01 - 2010.12
Short Course - Surveillance of non-communicable diseases
Harvard Medical School- Dubai Healthcare City
DubaiSkills
- Health Systems Strengthening
- Senior Stakeholder Engagement
- Capacity Building
- Community Outreach Planning
- Multi-sectoral Collaboration
- Programme Delivery
- Project Management
- Programme Implementation
- Donor reporting
- Health Information Systems
- Electronic Medical Records
- Case Management
- Medical Billing/Administration
- Managed Healthcare Systems
Volunteer Activities
Red Ribbon Foundation, Board Chairperson
Publications
- Bridging the Gap: Quality Improvement for National Core Standards – 1st Author Joint PHASA/RUDASA Conference – Bloemfontein 1 September 2012
- Impact of a tracking tool on the implementation of universal HIV testing policy at 18 months in Gert Sibande District , Mpumalanga – 2nd Author 20th International AIDS Conference, Melbourne Australia 2014
Computer Skills
- PowerBI
- MS Excel
- MS Word
- MS PowerPoint
- MS Outlook
- SharePoint
- Google sheets
- Google Forms
Drivers License
Valid Code 08
Timeline
Independent Contractor – Program Support
Anova Health Institute
2026.03 - 2026.04
HTS(HIV Testing Services) Manager
Anova Health Institute
2019.06 - 2025.02
Assistant Programme Manager
Kheth'Impilo
2019.03 - 2019.05
Technical Specialist QA
BroadReach Healthcare
2010.10 - 2018.11
Case Manager(Locum)
Panorama Medi-Clinic
2010.06 - 2010.09
Higher National Certificate - Total Quality Management
University of South Africa
2010.01 - 2010.12
Deployment Lead
Hospiserve Healthcare
2009.08 - 2010.03
Consultant – +Healthcare Consulting - Dubai (UAE) (Freelance) Quality Improvement Coordinator - Clinical Services
Al Noor Hospital Group
2007.12 - 2009.02
Case Manager(Locum)
Cape Town Medi-Clinic
2007.02 - 2007.07
Supervisor - Utilization Care Review
Saad Specialist Hospital
2004.06 - 2006.06
Case Manager
Kingsbury Hospital
2001.06 - 2004.04
Hospital Authorisations
Metropolitan Health
1995.07 - 2001.05
Claims Assessor
Bankmed Medical Aid
1987.02 - 2001.04
Diploma - General Nursing
Carinus Nursing College
1983.01 - 1986.12
Senior Certificate -
Lyceum College
1979.01 - 1983.12
Short course - Healthcare Risk Management
Health Authority Abu Dhabi
Short Course - Integrated HIV/TB Management
Kheth'Impilo
Short Course - Surveillance of non-communicable diseases
Harvard Medical School- Dubai Healthcare City