Medical Advisor Manager

1 month ago


Pretoria, Gauteng, South Africa Growthlink Consulting Full time
Job Title: Medical Advisor Manager

Growthlink Consulting is seeking a highly skilled Medical Advisor Manager to join our team.

Key Responsibilities:
  • Manage the administrative function in the Medical Advisory Services business unit
  • Contribute to and conduct targeted research into local and international clinical guidelines and funding policies
  • Critical review and analysis of current cost drivers and trends and compare with those of local and international sources for best practice
  • Assist in the management and monitoring of clinical cost targets
  • Assist in developing and maintaining adequate knowledge of data handling and interpretation of information translating interventions
  • Chair and coordinate monthly SPN meetings
  • Perform Service Level Agreement quarterly site visits
  • Support in the management and monitoring of SPNs to implement and give results within set targets
  • Support in the management of divisional budget in line with budget allocation
  • Assist in improving member value
  • Monitor project/programme in conjunction with the internal Project Management Unit of the Scheme
  • Ensure that all relevant projects are carried out and finalised
  • Liaise with SPNs on operational matters
  • Represent the Healthcare Management Division at SPN and External Stakeholder Engagements, including but not limited to Schemes Provider Summits, industry conferences, member Makgotlas, SAPS, BHF, DPSA, various other external stakeholders
  • Represent the Healthcare Management in external stakeholder events
  • Assist in the process for development and maintenance of Medical Advisory Services standard operating procedures and policies
  • Assist the Medical Advisory Services in providing clinical support to Healthcare Management and the Schemes other divisions in their external stakeholder-related matters
  • Support Provider Relations and Network engagements (quarterly hospital efficiency, provider society and groups and other forums as required)
  • Clinical review of hospital and provider efficiency and network reports
  • Advise the Scheme on existing and new alternative reimbursement models received from external stakeholders
Requirements:
  • Minimum MBChB/ MBBCh. Must be registered with the HPCSA
  • Qualifications in Health Technology Assessment or Evidence-Based Medicine would be advantageous
  • At least five (5) years work experience in the healthcare funding / medical scheme industry with at least two (2) years at manager/supervisor level
  • Experience in the evaluation of health technology assessments would be advantageous
  • Must have experience in the development and presentation of management reports
  • A good understanding of coding (Nappi, Tariffs, ICD10, CPT4, UPFS and more)
  • A good understanding of the South African Healthcare Industry
  • A good understanding of the Medical Schemes Act
  • The ability to conduct research using a variety of academic and market-related resources
Desirable:
  • Sound understanding of the medical schemes industry


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