Senior Specialist: Clinical Risk Management Support

1 week ago

Johannesburg Metropolitan Area, South Africa AfroCentric Group Full time R900 000 - R1 200 000 per year

What will you do?

To form a component of the GEMS: clinical risk management/ fund management support structure. Conduct research and draft documentation and spearhead internal projects related to the work of the clinical risk or fund management teams. Support the Advanced Specialist: Strategic Sourcing with the development of the strategic sourcing strategy through the identification of cost drivers

drivers including gathering of relevant data from various sources.

  • Provide effective and valuable input and guidance to the scheme to support the management of clinical risk
  • Oversee the specific SPN relationship together with the fund manager and or senior/advanced clinical risk specialist
  • The requirement is to ensure that all SPN operations concerns and requirements are communicated to the Fund managers for awareness and assist with actioning where required with internal role-players
  • Perform the majority of medicines-related action items and tactical responses arising from the Scheme meetings
  • Preparation of slides for various meetings to address medicines related agenda items and strategic inputs
  • Presentation of slides at meetings and fielding of questions
  • Handling of Scheme queries and tactical responses as they relate to all medicines matters, including but not limited to: Vaccination, MEL and MPL impact analyses, stock-outs and their impact, trend anomalies and expert panels
  • Co-ordination and secretariat for Expert Panels
  • Development of Medicine proposals
  • Development of Medical Device proposals
  • Ad-hoc analyses to support proposals
  • Ad-hoc medicine requests
  • Ad-hoc appliances request
  • Participate in various strategic projects

Qualification and Experience:

  • Qualified Pharmacist or Clinical Qualification
  • 6 - 8 years' experience in managed care, claims, clinical coding and data analysis
  • Knowledge of legislation, industry, PMB, NHI

Knowledge and Skills:

  • Knowledge and application of relevant legislation
  • Knowledge and application of processes and procedures
  • Product and scheme rule knowledge

Turnaround Time

The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of line managers.

Our Commitment to Transformation

AfroCentric is committed to transformation and embracing diversity. Our Employment Equity plan and targets will be considered as part of the recruitment process. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce, representative of the demographics of our society as well as people with disabilities.

Should you not hear from us within a month of applying, consider your application unsuccessful.

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