Manager: Medical Advisor

2 weeks ago


Pretoria, South Africa Growthlink Consulting Full time

Manager: External Stakeholder Support (Medical Doctor)
Medical Scheme
Pretoria
KPAs
ü
Manage the administrative function in the Medical Advisory Services business unit
ü
Contribute to and conduct targeted research into local and international clinical guidelines and
funding policies.
ü
Critical review and analysis of current cost drivers and trends and compare with those of local and
international sources for best practice.
ü
Assist in the management and monitoring of clinical cost targets
ü
Assist in developing and maintaining adequate knowledge of data handling and interpretation of information
translating interventions.
ü
Chair and coordinate monthly SPN meetings
ü
Perform Service Level Agreement quarterly site visits
ü
Support in the management and monitoring of SPNs to implement and give results within set targets
ü
Support in the management of divisional budget in line with budget allocation
ü
Assist in improving member value
ü
Monitor project/programme in conjunction with the internal Project Management Unit of the Scheme
ü
Ensure that all relevant projects are carried out and finalised
ü
Liaise with SPNs on operational matters
ü
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
ü
Represent the Healthcare Management in external stakeholder events
ü
Assist in the process for development and maintenance of Medical Advisory Services standard operating
procedures and policies.
ü
Assist the Medical Advisory Services in providing clinical support to Healthcare Management and
the Schemes other divisions in their external stakeholder-related matters
ü
Support Provider Relations and Network engagements (quarterly hospital efficiency, provider society and
groups and other forums as required).
ü
Clinical review of hospital and provider efficiency and network reports.
ü
Advise the Scheme on existing and new alternative reimbursement models received from external
stakeholders
Requirements
ü
Minimum MBChB/ MBBCh. Must be registered with the HPCSA
ü
Qualifications in Health Technology Assessment or Evidence-Based Medicine would be advantageous
ü
At least five (5) years work experience in the healthcare funding / medical scheme industry with at least
two (2) years at manager/supervisor level
ü
Experience in the evaluation of health technology assessments would be advantageous
ü
Must have experience in the development and presentation of management reports
ü
A good understanding of coding (Nappi, Tariffs, ICD10, CPT4, UPFS and more
ü
A good understanding of the South African Healthcare Industry
ü
A good understanding of the Medical Schemes Act
ü
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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