Senior Cost Controller

1 week ago


Pretoria, Gauteng, South Africa Mecs Africa Full time

We are looking for a Clinical Research Specialist with the following key knowledge areas:

  1. Basic understanding of evidence-based medicine.
  2. Knowledge of health data standards.
  3. Knowledge of managed healthcare or financial risk assessment principles.
  4. Knowledge of standards within the health industry.
  5. Knowledge of the legislation governing company policies and procedures.
  6. Knowledge of the National Health Act, Company Act, and other health-related legislation such as the Medical Scheme's Act.

Qualifications and Experience:

  1. Bachelor's Degree / Advanced Diploma in Health Sciences, Nursing, or Pharmacy-related qualification.
  2. Valid registration with the relevant statutory body (SANC, SAPC, HPCSA, etc.).
  3. Certification in evidence-based medicine and/or treatment protocol development will be an added advantage.
  4. Relevant 5 - 7 years' experience in a Managed Healthcare environment or similar in data sourcing, collection, and navigation.
  5. Experience working with treatment protocols and guidelines.
  6. Experience working with medical databases, navigating large data quantities and data outputs.
  7. Experience working with ICD 10 codes, CPT codes, NAPPI codes.
  8. Experience in Functional Capacity Evaluation and associated reports and tariffs applicable.

Key Performance Areas:

  1. Organize and manage health information data and ensure its quality, accuracy, accessibility, and security.
  2. Maintenance, collection, and analysis of data.
  3. Policy review and implementation.
  4. Reporting.
  5. Stakeholder management.
  6. Administrative and report writing.

Technical, Managerial, and Behavioral Competencies Required:

  1. Communication.
  2. Network and alliances.
  3. Planning, organizing, and coordinating.
  4. Ethics and values.
  5. Client service orientation.
  6. Change management.
  7. Conflict management.
  8. Policy conceptualization and formulation.
  9. Stakeholder development and relations.
  10. Knowledge of medical terminology and legal aspects of health information.
  11. Good understanding of data search engines and intelligent data extraction.
  12. Understanding of data research principles.
  13. Ensure quality, accuracy, accessibility, and security of data.
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