Senior Manager Clinical Consulting Services

5 months ago


Pretoria, South Africa Thusa Batho Labour Solutions Full time

The purpose of the job is to oversee the provision of Clinical services, administer the Prescribed Minimum Benefits (PMB) portfolio to ensure medical scheme members are protected and their entitlements are guaranteed, and to develop and implement the Prescribed Minimum Benefits regulation strategy. As a Senior Manager: Clinical Consulting Services you will be responsible for:

- **Driving the implementation of Clinical Consulting Services planned activities and projects**:

- Oversee the functioning of the Clinical Consulting Services sub-division by managing the sub-division projects and day
- to-day function of the Clinical unit including performance management, development, and implementations of operational

plans.
- Facilitate clinical support to other sub-division such as Benefits Management, Research & Monitoring, Legal Services etc.

**Coordinating and participating in the development of Prescribed Minimum Benefit definition and review**:
economic skills.- Support the analysis of Scheme Risk Measurement with epidemiological input (analyses and interpretation of disease

trends and costs.

**Adjudication of clinical opinions**:
- To oversee the provision of evidence based, quality and meticulous clinical opinions.- To provide feedback on clinical enquiries and opinions to external stakeholders.

**Coordinate Clinical Review Committee**:
- To coordinate clinical review committee meetings, monitor, report and manage Clinical Review Committee (CRC)

activities.- To participate in the appeals committee and provide clarity to the appeal committee on clinical opinions that informs rulings.

**Provide support to National Department of Health**:
- To attend meetings and provide inputs to National Department of Health committees related to CMS work.- To implement ad-hoc national health policy projects and provide policy directive.

**Undertake assignments/tasks allocated by line manager in accordance with operational requirements.**

**Benefits**:
The total annual package for the position is **R 1,457,375.00



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