
Geraldine Bonnetta Petersen
Managed Healthcare Services Professional
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About
I am a qualified healthcare services professional with extensive experience in managed healthcare, supported by strong leadership, strategic planning, and operational management capabilities. Throughout my career, I have successfully led teams and initiatives focused on optimizing serve delivery, enhancing quality of care and improving operational efficiency. I am detailed oriented and skilled in making critical decisions, managing competing priorities, meting deadlines and conducting performance and team reviews.
My strengths include analytical thinking, quantitative problem solving, and ability to identify opportunities for continues improvement that contribute to organizational growth and success. With 18 years of experience in managed healthcare, I have a proven track record of commitment, professionalism, and excellence in service delivery.
Experience
Care Coordinator at Bonitas Case Management (2025-01 – 2026-06)
Contracting position.
- Assessing patients' clinical needs by reviewing medical information, diagnoses, treatment plans and progress reports against scheme rules.
- Coordinating care between healthcare providers, hospital, specialists, rehabilitation facilities, and other service providers.
- Facilitating access to appropriate healthcare services and ensuring members receive the level of care required.
- Monitoring hospital admissions and lengths of stay and level of care to ensure treatment remains medical necessary.
- Authorizing or recommending funds for treatments, procedures, admissions, and rehabilitation services according to clinical guidelines and scheme rules.
- Discharge planning, including arranging follow – ups care, home base care, rehabilitation, or other support services.
- Identifying high risk or complex cases that require ongoing management and intervention.
- Ensuring compliance with clinical protocols, fund rules, healthcare regulations, and evidence-based practice.
- Managing healthcare costs while maintaining quality patient outcomes.
- Liaising with healthcare professionals such as doctors, nurses etc. to achieve the best possible patient outcomes.
Body Stress Release Practitioner at SA Body Stress Release Association (2022-05 – Present)
study BSR
Hospital Operations Manager - pre-auth and case manager (Bonitas) at Medscheme Holding (2016-07 – 2022-04)
- Managing and supporting team leaders and high-level query consultants.
- Setting performance targets and monitoring team productivity.
- Conducting performance reviews, coaching, mentoring and staff development.
- Managing staffing requirements, workloads, and resource allocation.
- Ensuring that hospital admissions, authorizations, and case management activities comply with clinical guidelines and benefit rules.
- Overseeing daily operations of the hospital benefits management department.
- Ensuring service level agreements (SLA's) and turnaround times are met.
- Managing workflow processes and identifying opportunities or improvement.
- Monitoring key performance indicators (KPI's)and departmental outcome.
- Managing hospital related healthcare expenditure.
- Identifying trends in utilization and areas of potential.
- Monitoring financial risk and ensuring appropriate benefit utilization.
- Building and maintaining relationships with hospitals, healthcare providers, the fund.
- Managing escalations from providers, hospitals, members and internal stakeholders.
- Collaborating with other departments such as claims, provider relations, and disease management.
- Ensuring compliance with healthcare legislation, medical scheme rules, organizational policies and regulatory requirements.
- Supporting audits and implementing corrective actions where necessary.
- Maintaining confidentiality and protecting member information.
- Analyzing utilization and performance data to identify trends and opportunities.
- Preparing management reports and recommendations.
- Contributing to departmental strategy, budget planning and organizational goals.
- Leading projects aimed at improving efficiency, quality and member outcomes.
- Attend monthly meetings with various hospital groups to strengthen collaboration and improve service delivery outcomes for all stakeholders.
Hospital Benefit Management - Team Leaders at Medscheme Holding (2009-06 – 2015-07)
- Coordinated team meetings daily to delegate tasks, communicate priorities and discuss goals.
- Manage team performance by communicating regular feedback and improvements required through appraisals.
- Recognized workflow challenges and delays, implementing remedial action to complete projects within targets.
- Eliminated non-value-add activity to improve operational processes and increase department profits.
- Responded to additional out-of-hours business needs through flexible working.
- Addressed staff concerns and sought remedial action to improve retention.
- Mentored colleagues to drive performance improvements against team objectives.
- Maintained up-to-date knowledge of current best practices, implementing improvements to meet industry standards.
- Produced weekly project reports to assess progress and identify areas of concern.
- Implemented absence management processes, addressing concerns to improve staff attendance.
- Determined overtime needs and budgeted well to remain within financial constraints.
- Planned and delegated team activity to meet productivity and performance targets.
- Identified automation opportunities to improve efficiency and reduce cost.
- Devised safe working policies to limit risk and meet compliance objectives.
- Assessed team capacity and capability against customer demand to plan shifts accordingly.
- Trained team members to full confidence and competency, uplifting department performance.
- Kept quality assurance documentation updated, organized and maintained for reliable records.
- Completed and escalated accident forms to reduce workplace risk.
- Introduced corporate initiatives to aid process improvements and achieve business objectives.
- Led training and development reviews, setting achievable goals and motivating staff to achieve them.
- Manage poor performances daily
Quality Assurance Coordinator at Medscheme (2008-03 – 2009-08)
- Performed investigations and assessments to determine areas of improvement.
- Consulted with customers to gather feedback and measure satisfaction levels and rectify complaints and issues.
- Executed regular upskilling to strengthen competence of team members and increase productivity.
- Monitored staff delivery and observation activity in accordance with company policy to determine adherence to programmed areas.
- Established protocols to reduce waste, lower costs and meet tight deadlines, enforcing discipline and compliance from team.
- Created and implemented staff training and development plans to support process improvements.
- Produced detailed progress reports to identify strengths and areas for improvement and common trends.
- Developed and evaluated specifications for products or processes to build new features and functionality.
- Assessed business and customer needs to determine objectives and implement structured plans.
- Studied customer needs and requirements to design potent quality control processes.
- Oversaw product development procedures to detect deviations from quality standards.
- Documented findings and feedback of products to maintain accurate and consistent inventory.
- Developed and implemented policies and procedures to establish compliance through regular company-wide training sessions.
- Mentored inspectors, technicians and teams provide feedback and ways to improve processes.
- Evaluated product recalls to determine roots of causes, develop new methods in improving discrepancies and avoid future occurrences.
- Segregated products to separate approved quality merchandise and rejected goods.
- Researched trends to stay up to date with latest technology and apply best practices.
- Conducted inspections of final outputs to compare materials to specifications, determining accurate requirements.
- Performed statistical analysis to calculate and determine quantity of products ready for distribution.
- Prepared requirements for raw material or intermediate products to enforce compliance from suppliers.
Inbound Call Centre Agent / Hospital benefit Manag at Medscheme (2006-09 – 2008-03)
- Increased customer satisfaction by offering friendly, helpful and informative customer service.
- Handled and quickly resolved customer issues regarding product sales and customer service problems.
- Maintained detailed product knowledge to competently and expertly advise customers.
- Applied correct hold and transfer procedures, consistently keeping call times within timeframe target.
- Recorded details from customer communications on CRM.
- Dealing with complex customer complaints professionally and politely, resolving issues with favorable solutions.
- Made high volume of sales calls per day exceeding company outbound call targets.
- Reviewed customer accounts and updated information about billing, shipping and warranties.
- Recorded details of caller's complaints and inquiries and outlined actions taken.
- Follow up customer calls with further information or instructions when necessary.
- Followed customer service script for uniformity in handling customer issues.
- Guided callers through troubleshooting, navigating company site and using products or services.
- Collaborated with other call center professionals to improve customer service.
- Documented and alerted management teams of trends in customer calls.
- Wrote and submitted timely reports on performance, targets and customer queries.
- Support with outbound calls to customers about specific sales and marketing promotional campaigns.
- Identified and pursued opportunities to upsell company products
Education
Matric
Enrolled Nurse
Harvard Management
Lean Sigma - yellow belt