Rules and Tariffs Master

A reputable Medical Aid is seeking a Rules & Tariff Master to join their Claims Department. This role will ensure that the tariffs and rules are loaded correctly on the Administration System and to maintain this function with regards to updates and changes. **Duties**: - Providing effective communication to staff and Management on changes in the industry,...

Main ResponsibilitiesGrowthlink Consulting seeks a skilled Clinical Advisor to join our team. The successful candidate will be responsible for managing the administrative function in the Medical Advisory Services business unit.Key Performance Areas:Manage the administrative function in the Medical Advisory Services business unitContribute to and conduct...

About Qetello Holdings: We are a leading medical scheme based in South Africa, dedicated to providing comprehensive healthcare benefits to our members. Our client is committed to innovation, quality service, and the well-being of their clients.Job Summary:We are seeking an experienced Medical Claims Examiner to ensure that all claims are assessed accurately...

Job Description:As a Senior Manager of Medical Advisory Services, you will play a critical role in executing clinical and medical advisory services within the Healthcare Management division. You will maintain clinical oversight on all aspects of the Schemes business, ensuring that clinical and medical advisory services are sound and in compliance with the...

The purpose of this position is to ensure that all claims are assessed using the appropriate rules and is paid correctly in line with the Scheme's benefit and tariff structures. **Duties**: - Assessing and processing Medical Aid claims - **Quality**:Measuring of individual error rate to ensure no costs incurred due to assessing errors made. -...

Job Title: Clinical Advisor ManagerAt Growthlink Consulting, we are seeking a highly skilled Clinical Advisor Manager to join our team. As a key member of our Medical Advisory Services business unit, you will be responsible for managing the administrative function and contributing to targeted research into local and international clinical guidelines and...

Key Performance Areas (KPAs):üManage the administrative function in the Medical Advisory Services business unitüContribute to and conduct targeted research into local and international clinical guidelines and fundingpolicies.üCritical review and analysis of current cost drivers, and trends and compare with those of local andinternational sources for best...

Key Performance Areas (KPAs): ü Manage the administrative function in the Medical Advisory Services business unit ü Contribute to and conduct targeted research into local and international clinical guidelines and funding policies. ü Critical review and analysis of current cost drivers, and trends and compare with those of local and international...

About the RoleWe are seeking an experienced and skilled Strategic Medical Services Director to join our team at Growthlink Consulting in Pretoria. This is a fantastic opportunity for a medical professional to utilize their expertise in clinical and financial risk management, benefit design, and more.ResponsibilitiesAssist the Chief Healthcare Officer in...

About UsGrowthlink Consulting is a dynamic and forward-thinking organization dedicated to providing expert consulting services in the healthcare industry.Job OverviewWe are seeking an experienced and highly skilled Senior Clinical Manager to join our team. As a key member of our Medical Advisory Services business unit, you will be responsible for managing...

Job Title: Audi, BMW, Mercedes-Benz Master TechnicianAbout the Job:Mototeam (Pty) Ltd is seeking an experienced Audi, BMW, and Mercedes-Benz master technician to join our team. As a highly skilled and qualified individual, you will be responsible for ensuring that all vehicles meet the highest standards of quality and performance.Key Responsibilities:•...

KPAsü Assist the Chief Healthcare Officer in executing all clinical and medical advisory services within the HealthcareManagement division and maintain clinical oversight on all aspects of the Schemes business.ü Ensure that the execution of clinical and medical advisory services within the Organisation are sound and incompliance with the Medical Schemes...

Job Title: Movement Operations Support SpecialistWe are seeking a highly organized and detail-oriented Movement Operations Support Specialist to join our team at IOM.Key Responsibilities: Coordinate and schedule travel for individuals upon receipt of travel-ready status and/or request in accordance with travel requirements. Organize and complete all bookings...

Key Performance Areas (KPAs): ü Manage the administrative function in the Medical Advisory Services business unitü Contribute to and conduct targeted research into local and international clinical guidelines and fundingpolicies.ü Critical review and analysis of current cost drivers, and trends and compare with those of local andinternational sources...

Medical Claims Examiner Job DescriptionAbout Our Client:Our client is a leading medical scheme dedicated to providing comprehensive healthcare benefits to its members. They are committed to innovation, quality service, and the well-being of their clients.Key Responsibilities:Assess all claims using the appropriate rules and guidelines.Ensure accurate and...

**Functions**: - Plan and optimise daily tasks to ensure timely updates of cases on the hospital list. - Follow up on long-term and high-cost cases of hospitalised and home care patients. - Identify the need for patient and hospital visits and provide documented feedback. - Adhere to the escalation process for cases requiring input from management or the...

Job SummaryQetello Holdings is seeking a dedicated and experienced Case Manager to join their team. The ideal candidate will have a B Cur Degree / Diploma in Nursing and a minimum of 5 years of experience as a nursing practitioner.Key Responsibilities:Plan and optimize daily tasks to ensure timely updates of cases on the hospital list.Follow up on long-term...

Job Title: Medical Case ManagerOur client, a leading medical scheme in Pretoria, is seeking a dedicated and experienced Case Manager to join their team. As a Case Manager, you will be responsible for planning and optimizing daily tasks to ensure timely updates of cases on the hospital list.Key Responsibilities:Follow up on long-term and high-cost cases of...

Job Title: Senior Healthcare StrategistWe are seeking an experienced Senior Healthcare Strategist to lead our clinical function and drive evidence-based clinical funding guidelines.About the Role:Develop, implement, and maintain our overarching clinical strategies that align with organisational goals.Oversee our clinical function, integrating best practice...

Our client is a leading medical scheme based in Pretoria, dedicated to providing comprehensive healthcare benefits to its members. They are committed to innovation, quality service, and the well-being of their clients. In line with their growth and commitment to excellence, they are seeking a dedicated and experienced Case Manager to join their...