Managed Care Consultant

4 days ago


Pretoria, Gauteng, South Africa Bestmed Medical Scheme Full time
Role Profile

We are looking for a highly skilled Healthcare Service Provider Specialist to join our team. As a key member of our organization, you will be responsible for delivering high-quality healthcare services to our members.

Your primary focus will be on managing the needs of our members, ensuring that they receive the best possible care and support. This includes verifying prosthesis limits, containing costs for both members and fund, and participating in ongoing training and development.

You will also be responsible for risk management, reducing the risk associated with hospital and authorized cases, as well as telephone etiquette, answering telephone calls in a way that achieves member satisfaction.

The ideal candidate will have a strong background in nursing, with at least 5 years of experience as a nursing practitioner and 1 year of experience gained in the medical funding industry.

Key Responsibilities
  • Delivering cost-effective managed healthcare services
  • Managing the needs of members
  • Verifying prosthesis limits
  • Risk Management: Reducing risk associated with hospital and authorized cases
  • Telephone Etiquette: Answering telephone calls to achieve member satisfaction
About Bestmed

Bestmed Medical Scheme is a leading provider of healthcare services in South Africa. We are committed to delivering high-quality services to our members, while promoting a culture of excellence, innovation, and teamwork.


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