Senior Cost Controller
1 week ago
We are looking for a Clinical Research Specialist with the following key knowledge areas:
- Basic understanding of evidence-based medicine.
- Knowledge of health data standards.
- Knowledge of managed healthcare or financial risk assessment principles.
- Knowledge of standards within the health industry.
- Knowledge of the legislation governing company policies and procedures.
- Knowledge of the National Health Act, Company Act, and other health-related legislation such as the Medical Scheme's Act.
Qualifications and Experience:
- Bachelor's Degree / Advanced Diploma in Health Sciences, Nursing, or Pharmacy-related qualification.
- Valid registration with the relevant statutory body (SANC, SAPC, HPCSA, etc.).
- Certification in evidence-based medicine and/or treatment protocol development will be an added advantage.
- Relevant 5 - 7 years' experience in a Managed Healthcare environment or similar in data sourcing, collection, and navigation.
- Experience working with treatment protocols and guidelines.
- Experience working with medical databases, navigating large data quantities and data outputs.
- Experience working with ICD 10 codes, CPT codes, NAPPI codes.
- Experience in Functional Capacity Evaluation and associated reports and tariffs applicable.
Key Performance Areas:
- Organize and manage health information data and ensure its quality, accuracy, accessibility, and security.
- Maintenance, collection, and analysis of data.
- Policy review and implementation.
- Reporting.
- Stakeholder management.
- Administrative and report writing.
Technical, Managerial, and Behavioral Competencies Required:
- Communication.
- Network and alliances.
- Planning, organizing, and coordinating.
- Ethics and values.
- Client service orientation.
- Change management.
- Conflict management.
- Policy conceptualization and formulation.
- Stakeholder development and relations.
- Knowledge of medical terminology and legal aspects of health information.
- Good understanding of data search engines and intelligent data extraction.
- Understanding of data research principles.
- Ensure quality, accuracy, accessibility, and security of data.
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