Senior Healthcare Strategist

1 week ago


Pretoria, Gauteng, South Africa Government Employees Medical Scheme RSA Full time
Job Title: Senior Healthcare Strategist

We 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 and ensuring compliance.
  • Strengthen stakeholder relationships, encourage collaboration, and innovate through our networks and provider relations strategies.
Key Performance Areas:
  1. Build and maintain robust healthcare networks, including hospitals, primary care, and specialist providers.
  2. Develop comprehensive strategies for managing tariffs and billing rules aligned with organisational goals.
  3. Progressively implement Alternative Reimbursement Arrangements (ARM) with all hospital groups.
  4. Develop policies for effective management of medicine formularies and exclusion lists.
  5. Implement value-based active disease risk management initiatives to improve patient outcomes.
  6. Maintain oversight of our managed care function and ensure compliance to Service Level Agreements (SLA).
  7. Foster strong relationships with healthcare providers to support strategic goals and initiatives.
Requirements:
  • Postgraduate MBCHB or equivalent in a related field, or Honours/Professional Qualifications.
  • Strong understanding of the South African Healthcare and Medical Scheme Industry.
  • Twelve years of functional experience, with at least five to eight years in a highly strategic Medical Scheme/Managed Healthcare Senior Management role.
Estimated Salary: R1 200 000 - R1 800 000 per annum

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