Medical Advisor

4 days ago


Johannesburg, South Africa Medical Placements Full time

EE Position
- The position report directly to the HOD: Hospital Benefit Management.

**THE IDEAL CANDIDATE SHOULD HAVE**:

- Must be a Medical Doctor registered with Health Professions Council of South Africa (HPCSA).
- Medical indemnity insurance will be an added advantage.
- Must have sound knowledge of the Medical Aid Industry, Rules & Regulations, and other related legislation.
- Sound knowledge of PMB guidelines and Industry knowledge would be an added advantage.
- Afrikaans language would be an added advantage.
- Excellent business writing & communication skills with exceptional telephone etiquette.
- Must have strong organisational awareness in order to anticipate the impact of actions on other groups.
- Time Management & good administration skills.
- Effective conflict resolution skills and the ability to work under pressure.
- Must be a strong team player and results driven.
- Computer literacy (MS Office).

**KEY RESPONSIBILITIES INCLUDE**:

- Advise the Managed Healthcare (MHC) group on clinical matters pertaining to, pre-authorization, case management, benefit management e.g. PMB’s, disease management and pharmaceutical benefit management, non disclosures etc. in order to ensure clinical appropriateness of benefits.
- Recommend various internal groups and the Scheme on clinical matters to ensure that the rules of the Scheme has been correctly applied and implemented.
- Assess individual cases in accordance with that diagnoses and clinical data motivation letter/benefit structure/Rules of the Scheme/clinical knowledge/experience to facilitate clinical appropriateness of benefits.
- Facilitate and provide clinical training to the MHC group to ensure the continuous updating of clinical knowledge and skills, as well as medical advancements.
- Amend appropriate training material as required to ensure the most up to date clinical information is available.
- Attend meetings, interdepartmental forums, benefit design workshops, third party representatives and the Scheme to provide clinical input and expertise where it may be required.
- Attend the Medical Advisory Group meetings/ conferences for the adoption of clinical policies and to keep abreast of industry trends, developments and norms.
- Research scientific clinical data in order to source advancements to keep abreast of industry trends, developments and norms and advise the Scheme on benefit design and reimbursements.
- Consult with medical specialists and professional bodies to obtain their expert opinions.
- Recommend alternative treatment plans using physician’s motivation letter/Benefit structure/Rules of the Scheme to ensure the most cost-effective treatment.
- Liaise with service providers to exchange information and discuss referred cases.
- Refer appeals to the Clinical Committee for a final decision and compile the official reply to the complainant in order to adjudicate the Clinical Committee's decision.
- Review and respond to clinical queries from CMS.



  • Johannesburg, South Africa bioMérieux Full time

    **bioMerieux South Africa** **Country Medical Advisor** We are looking for a Medical Advisor who will work and grow within Medical Affairs unit. The Medical Advisor will contribute to the Medical Affairs activities in the country - in interaction with Regional Medical Affairs and will report directly to the General Manager. **What will your...

  • Medical Advisor

    2 weeks ago


    Johannesburg, Gauteng, South Africa Aspen Pharma Group Full time

    Job title : Medical Advisor (JHB North)Job Location : Gauteng, JohannesburgDeadline : March 18, 2025Quick Recommended LinksJobs by Location Job by industries OBJECTIVE OF ROLEThis position is a strategic position for a Medical Advisor Benign Haematology within the Medical Affairs organization. The Medical Advisor will provide strategic input into the...


  • Johannesburg, South Africa Novo Nordisk Full time

    x **Regional Medical Advisor - Obesity** **South Africa** If data could speak, it would say that 87% of healthcare professionals never received advanced training on obesity after medical school1. In fact, 69% of adults living with obesity even report experiences of stigmatization from HCPs2, leaving 81% to feel weight loss is their sole responsibility3....

  • Medical Advisor

    1 week ago


    Johannesburg, South Africa Specd Full time

    **JOB DESCRIPTION** *** **Job title**:Medical Advisor **Location**:Randburg **ROLE PURPOSE**: To provide a medical advisory function within the Clinical Risk Division and Scheme to ensure the limiting of the Schemes exposure and to inform key strategic decisions. **KEY AREAS OF RESPONSIBILITY**: - Provide input into the development of the sub-divisions...

  • Medical Advisor

    4 weeks ago


    City of Johannesburg Metropolitan Municipality, South Africa Aspen Pharma Group Full time

    Job title : Medical Advisor (JHB North)Job Location : Gauteng, JohannesburgDeadline : March 18, 2025Quick Recommended Links Jobs by Location Job by industries OBJECTIVE OF ROLE This position is a strategic position for a Medical Advisor Benign Haematology within the Medical Affairs organization. The Medical Advisor will provide strategic input into the...


  • Johannesburg, South Africa Organon Full time

    **The Position** The Medical Advisor holds primary responsibility within the country for the development and execution of the Medical Affairs Plans in his/her therapeutic areas under the guidance and supervision of the Country Medical Lead. Additionally, the Medical Advisor provides Medical Affairs therapeutic area support through engaging with Scientific...


  • Johannesburg, South Africa Complement Recruitment Full time

    **Nurse Clinical Advisor - Johannesburg Gauteng** **Salary: Market Related** **Purpose of Position**: Complement Recruitment are recruiting for a Nurse Clinical Advisor for a permanent position in Sandton, Johanensburg, Gauteng. This is a call-centre based nurse delivering care and clinical support and advice through virtual consultations with consumers...

  • Clinical Advisor

    7 days ago


    Johannesburg, South Africa Select One Full time

    In this role, the Clinical Advisor will seek to align clinical solutions with clinical and business objectives and build relationships and credibility with key stakeholders effectively. Duties will include but not be limited to: - Serving as the clinical expert providing technical support to the Managed health care department - Contributing to the refining...

  • Financial Advisor

    4 weeks ago


    Johannesburg, South Africa Inevo Consulting Full time

    About the role: The Financial Advisor specialising in Health will be responsible for acquiring, retaining, and growing a client base for Curemed’s health-related products. This role involves providing expert advice through comprehensive financial planning and delivering an excellent client experience. The advisor will cater to various market segments,...


  • Johannesburg, South Africa LKB Consult Full time

    Are you ready to make a real difference in the financial world? We’re offering a unique platform for established advisors to elevate their potential and achieve new levels of success! **For Established Advisors**: Take your career to new heights with the backing of one of South Africa’s largest financial networks. You'll benefit from cutting-edge tools,...


  • Johannesburg, South Africa Unique Personnel Full time

    **Job Number** - 68194 **Job Type** - Permanent **Job Title** - Health Specialist/Admin/Advisor **Computer Skills** - Ms Office **Industry** - Financial Services **City** - Johannesburg **Province** - Gauteng - Phone prospects and quote on various medical aid options (existing client’s and Discovery Health leads) - Sourcing new business and cross...


  • Johannesburg, Gauteng, South Africa The Recruitment Council Full time

    Job Title: Financial Advisor Support Administrative RoleWe are seeking a dedicated and dynamic individual to join a growing advisory firm as a Financial Advisor Support. This role is primarily administrative, offering a great opportunity for someone with a passion for organization and accuracy to assist financial advisors in managing client portfolios and...

  • Financial Advisor

    1 week ago


    Johannesburg, South Africa Micah Govender Developments Full time

    **Business Description**: Personal Finance provides clients in the entry, middle, affluent and self-employed markets in South Africa with a comprehensive range of financial service solutions to facilitate their long term wealth creation, protection and niche financing needs. Company is looking for experienced life and investment financial planners to be...


  • Johannesburg, South Africa Vantage Data Centers Full time

    About Vantage Data Centers Vantage is committed to being a workplace of inclusion, equity, respect and acceptance. We celebrate diversity and intentionally seek out opportunities to learn from one another’s experience. Vantage Data Centers powers, cools, protects and connects the technology of the world’s well-known hyperscalers, cloud providers and...


  • Johannesburg, South Africa Complement Recruitment Full time

    Complement Recruitment are recruiting for a Nurse Clinical Advisor for a permanent position in Sandton, Johannesburg, Gauteng. This is a call-centre based nurse delivering care and clinical support and advice through virtual consultations with consumers over the phone, and in the near future, in person as well. Motivated, committed, and collaborative...


  • Johannesburg, South Africa Vantage Data Centers Full time

    À PROPOS DE VANTAGE DATA CENTERS Vantage s’engage à être un lieu de travail d’inclusion, d’équité, de respect et d’acceptation. Nous célébrons la diversité et cherchons intentionnellement des occasions d’apprendre des expériences de chacun. Vantage Data Centers alimente, refroidit, protège et connecte la technologie des plus grands...

  • Financial Advisor

    4 weeks ago


    Johannesburg, Gauteng, South Africa HR Studio Ltd Full time

    Were looking for A highly driven, money hungry, and motivated individual to become a Financial Advisor. You must be outgoing, a people person, and be able to successfully handle a high-pressure environment. Whats the role? You will be responsible for : The role at a glance is about championing our clients valued customers to achieve their lifetime goals by...


  • Johannesburg, South Africa Servier Laboratories South Africa (PTY) Ltd. Full time

    **KEY RESPONSIBILITIES** To generate sales through building trusted advisor relationships with healthcare professionals in ways that add value to their practices and their patients. To co-ordinate and host educational, informative Continual professional development accredited events for industry professionals and key opinion leaders. **Core...


  • Johannesburg, Gauteng, South Africa GJM Ultra Brokers Full time

    Job SummaryWe are seeking a highly motivated Customer Relationship Specialist to join our team at GJM Ultra Brokers. As a key member of our sales force, you will be responsible for building and maintaining relationships with medical professionals in the East Rand area.About the RoleIn this dynamic and fast-paced environment, you will work closely with our...


  • Johannesburg, Gauteng, South Africa GJM Ultra Brokers Full time

    Join Our TeamWe are looking for a Business Development Associate to join our team at GJM Ultra Brokers. As a key member of our sales force, you will be responsible for building and maintaining relationships with medical professionals in the East Rand area.About the RoleIn this dynamic and challenging environment, you will work closely with our financial...