Specialist Provider Networks- Medical Aid Experience

2 weeks ago


Johannesburg, Gauteng, South Africa Medical Placements Full time
The role manages effectiveness and efficiency of managed care programme performance through MCO SLA management.

The role reviews MCO's provider networks in terms of coverage, efficiency, growth and profiling to drive positive member health outcomes.

Accountable for the implementation of tactical work plans and formulate associated procedures to minimise the financial risk of the Scheme by implementing, maintaining, and improving the defined managed care programs, providing clinical support for maintaining the acceptable level of quality and cost-effective risk measures.


Qualification & Experience
NQF Level 7 Degree qualification in Health or relevant Nursing Qualification

6 years' experience in managed care and provider network management
Deep knowledge of managed care. Travel
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