VIROSHNEE MATADIN

Key Responsibilities & Experience Qualifications & Compliance Technical Skills & Knowledge Personal Attributes & Competencies

• Manage incoming calls from hospitals regarding casualty and admission authorisation including benefit availability, benefit limitations, and collection of relevant clinical information.
• Identify exclusions at the onset of treatment requests to ensure correct benefit application.
• Conduct end to end case management from issuing pre-authorisation letters through to final discharge and required follow-up treatment.
• Vet hospital accounts in accordance with the gazette , ensuring compliance with approved tariffs, clinical guidelines, and internal protocol
• Ensuring adherence to case management procedures and facilitating communication between all role-players and patient coordination .
• Audit all captured accounts and align claims with authorisations on MIP , assessing clinical appropriateness and exercising sound medical judgement to prevent overcharging.
• Negotiate discounts with healthcare providers where applicable.
• Process claims and provide clear detailed feedback to service providers.
• Manage clinical risks by promoting effective principles and strategies to reduce over-utilisation and inappropriate claims.
• Maintain confidentiality and ensure compliance with Service Level Agreements
• Perform risk and disease management functions across member cases.
• Classify and prioritize risks based on the frequency of members visits to healthcare providers.
• Support and contribute to reports on case statistics and overall case management processes.
• Monthly Case Manager Work Schedule
• Monitor and manage over utilisatin trends across general practitioners and hospitals.
• Conduct age analysis including hospital group–specific reporting.

Compliance

• FAIS Compliant
• FICA Compliant
• POPIA Compliance
• IT Policy Compliance
• Treating Customers Fairly (TCF)
• Conflict of Interest Compliance

Competency and attributes include

• Strong attention to detail
• Health risk assessment knowledge
• Computer literacy
• Accountability
• Strong communication skills
• Business writing proficiency
• Efficient and effective mindset
• Planning and organisational skills
• Resilient and adaptive
• Commitment to self-development
• Values-driven and purpose-oriented
• Ethical and professional conduct

Duties Performed

Primary Health Care Nurse

• Provided comprehensive primary healthcare service to patients across all age groups.
• Administered baby and childhood vaccines in line with the national Expanded Programme on Immunization (EPI).
• Conducted antenatal assessment including antenatal classes, basic maternal health screening, and health promotion.

• Performed basic clinic assessments , including history taking and physical examinations.
• Managed minor ailments and provided health education and counseling to patients
• Supported and participated in private health campaigns , including immunization drives and community health initiatives.

Reason for leaving : Clinic closed

Primary Health Care Nurse / Healthcare Nurse

· Provided comprehensive primary health care nursing services, including acute patient care and ongoing patient management.

· Performed nursing management duties, ensuring efficient clinic operations and adherence to clinical protocols.

· Delivered mental health care support, including basic mental health assessments, patient support, and appropriate referrals.

· Managed medical stock control, including ordering, monitoring expiry dates, and ensuring availability of essential medical supplies.

· Ensured pharmacovigilance, including safe medication practices, adverse drug reaction monitoring, and reporting.

· Conducted case management, coordinating patient care and follow-up treatment plans.

· Functioned as a Wellness Nurse, providing health screenings, preventive care, and health education.

· Administered baby immunisations in line with national vaccination schedules.

· Provided wound care management, including assessment, cleaning, dressing, and follow-up.

· Facilitated nurse-led VideoMed consultations, supporting online doctor consultations and remote patient care.

· Acted as a Healthcare Nurse representative, demonstrating VideoMed services to nurses, corporate clients, and investors for Healthforce.

Reason for Wanting to Leave: Role impacted by business acquisition

Duties Performed

Primary Health Care Nurse

• Delivered comprehensive primary health care services to individuals and families.
• Conducted wellness assessments, including health screenings, risk identification, and preventive care education.
• Provided family planning services, including counselling, education, and administration of contraceptive methods in line with clinical guidelines.
• Offered baby care services, including growth monitoring, developmental assessments, basic health education, and parental support.
• Maintained accurate clinical records and ensured compliance with healthcare protocols and standards.
• Demonstrated independent decision-making and adaptability, effectively managing patient care in a locum capacity across different clinical settings.
• Utilised digital systems and basic healthcare technology for patient documentation and reporting where applicable.

Reason for Leaving: contract-based role-New Mum

Duties Performed

Team Leader – Emergency Nursing

· Demonstrated proficiency across all areas of emergency nursing care and healthcare delivery, with a strong emphasis on high-quality emergency care and positive patient interaction.

· Led and supported the emergency care team, ensuring efficient patient flow, adherence to clinical protocols, and optimal standards of care.

· Provided urgent medical care to patients in the Emergency Room, including stabilisation of acute conditions, pain management, and reduction of patient discomfort.

· Administered medications safely and accurately in line with scope of practice and emergency protocols.

· Acted as a strong patient advocate, ensuring patient safety, dignity, and informed care decisions.

· Promoted health education and health promotion, even within high-pressure emergency settings.

· Supported clinical decision-making and escalated care appropriately when required.

Reason for Leaving: Seeking locum work

Duties Performed

Registered Nurse – Inpatient and Emergency Care

• Provided comprehensive nursing care across multiple hospital units, including Medical Ward, Surgical Ward, ICU (Adult and Pediatric), and Trauma/Emergency Unit.
• Managed and coordinated care for patients with diverse and complex medical and surgical conditions.
• Monitored patient progress, administered medications, and implemented treatment plans according to hospital protocols.
• Supported critical care interventions in ICU settings, including patient monitoring, ventilator support, and emergency response.
• Assisted in trauma and emergency care, stabilising critically ill patients and facilitating rapid interventions.
• Maintained accurate patient records, ensuring compliance with clinical guidelines and quality standards.
• Collaborated with multidisciplinary teams to optimise patient outcomes and ensure continuity of care.

Reason for Leaving: Newly married – relocation