Pharmacist Assistant

7 days ago

Midrand, South Africa Pharma plan Pty ltd Full time

SUMMARY:
Registered Pharmacy Assistant needed to fill a Wellness Specialist opening.

POSITION INFO:
Scope of Responsibility:

- Assist in the continuous improvement of comprehensive wellness / disease management programmes.
- To develop a method and agree with the funder / employer onsho w to manage and operationalise beneficiary disease registrations and reimbursement.
- Analyse clinical, utilisation, and other data of members and healthcare providers.
- Share data and interventions with others within the managed care and administration teams, ensuring optimal patient care and minimising utilisation.
- Identify trends in utilisation, fraud, and other factors. Ensure efficient Customer Service and compliance to agreed SLA-s.
- Manage and maintain data integrity and update accordingly where necessary.
- Important Company input and / or develop other processes to manage utilisation more efficiently.
- Ensure all enquiries are resolved satisfactorily and customer requirements within business rules and costing factors are maintained.
- Regularly review all approved claims and ensure that all are settled according to correct tariffs and Nappi codes.
- Supply monthly management reports.
- Maintain the chronic medication benefit rules, registration, and compliance reporting.
- Ensure an optimal interface with the PM provider to facilitate beneficiary registrations for listed chronic medicine programs.
- Coordinate services by contracted providers to deliver annual wellness screenings and services for example health days.
- Liaise with enrolled members to ensure adequate funding and compliance to a Care-map.
- Any other duties as assigned by your supervisor from time to time.

Qualifications:

- Matric
- Registered Pharmacy Assistant
- Valid membership of the South African Pharmacy Council
- Claims and Forensic Risk management certification will be an advantage

Skills and Experience:

- At least 2 years
- experience as a registered Pharmacy Assistant.
- Sound understanding of the South African Health Industry, benefits, options, etc
- MIP

Application System experience and advantage.
- Ability to liaise with external parties
- clinicians and members
- ICD codes, modifiers, and RPL tariff knowledge and understanding.
- Ability to liaise with external parties
- clinicians and members. Ability to work within an established team.
- Excellent oral and written communication skills.
- Customer-centric attitude.
- Excellent analytical skills and pays attention to detail.
- Computer literate
- MS Office suite, i.

**Salary**: R9,500.00 - R15,000.00 per month

Ability to commute/relocate:

- Midrand, Gauteng: Reliably commute or planning to relocate before starting work (required)

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