Senior Manager: Clinical Consulting Services

3 days ago

Johannesburg, South Africa Digital Spaces Allegiance 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 of 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 dayto-day function of the Clinical unit including performance management, development, and implementation of operational plans. - Facilitate clinical support to other sub-divisions such as Benefits Management, Research & Monitoring, Legal Services etc.
- 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 the 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 the line manager in accordance with CMS’ operational requirements.

**SKILLS AND KNOWLEDGE BASE**
- Bachelor of Medicine and Bachelor of Surgery (MBChB) or a degree in Medicine with post graduate training in Epidemiology and Public Health at NQF level 8;
- Master’s degree qualification in Public Health will be an added advantage;
- Completed Internship and Community service;
- A valid Health Professional Council of South Africa (HPCSA) Certificate; and
- A minimum of 12 years’ experience in the Medical Schemes and/or Healthcare environment, of which 5 years must be in Evidence-Based Medicine & Clinical Management, and 7 years at the Management/Supervisory level.

**Training and Knowledge areas**:

- Knowledge of related legislation impacting on and influencing the functioning of the organisation (MSA, PFMA, CPA, Constitution etc);
- Knowledge of public health and health care industry;
- Good knowledge of medical system and health management and clear understanding of the health policy implementation landscape;
- Stakeholder management;
- Understanding of information management;
- Understanding community challenges and opportunities relating to the mission of the organization; and
- Computer Literacy.

Training and Knowledge areas:

- Knowledge of related legislation impacting on and influencing the functioning of the organisation (MSA, PFMA, CPA, Constitution etc);
- Knowledge of public health and health care industry;
- Good knowledge of medical system and health management and a clear understanding of the health policy implementation landscape;
- Stakeholder management;
- Understanding of information management;
- Understanding community challenges and opportunities relating to the mission of the organization; and
- Computer Literacy.

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

Application Question(s):

- Do you have a valid Health Professional Council of South Africa (HPCSA) Certificate

**Education**:

- Bachelors (required)

**Experience**:

- Healthcare environment: 10 years (required)

Ability to Commute:

- Johannesburg, Gauteng (required)

Ability to Relocate:

- Johannesburg, Gauteng: Relocate before starting work (required)

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