Lead Clinical Advisor

6 days ago


Pretoria, Gauteng, South Africa Federated Employers Mutual Assurance Company (RF) Proprietary Limited (FEM) Full time

The Head of Clinical Services at FEM will lead a team of medical professionals who are responsible for managing claims and providing support to policyholders. The successful candidate will have extensive experience in clinical settings and healthcare management, as well as strong leadership and communication skills.

The role involves analyzing medical management trends, developing policies, procedures, and processes, and providing oversight and guidance for all complex claims escalated to the Head of Clinical Services.

Key Responsibilities:

  • Develop and implement medical management strategies to optimize claim outcomes.
  • Analyze medical management trends and develop policies, procedures, and processes.
  • Provide oversight and guidance for all complex claims escalated to the Head of Clinical Services.
  • Establish positive working relationships with healthcare providers.

Requirements:

  1. A qualified doctor with an MBChB degree, registered with the HPCSA.
  2. Over 10 years of clinical experience in a hospital or private practice setting, with healthcare management experience.
  3. More than 5 years of management experience, overseeing a team of 10 or more people.
  4. Previous experience in the medical aid industry is advantageous.
  5. Knowledge of the Compensation for Occupational Injuries and Diseases Act (COIDA) is also beneficial.
  6. Ability to collaborate effectively with the team and drive optimal performance.


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