Consultant Medical Management 3 Year Contract
Johannesburg, Gauteng, South Africa
Job Description
Qualifications:
- Bachelors Degree/Advanced Diploma in Health Sciences /Medical related qualification.
- Registration with HPCSA/SANCA
- Medical management
- Conduct medical assessment and compile injury assessment reports.
- Conduct assessments and bill reviews on submitted claims, focusing on the appropriate level of care, the length of stay, and quality of care.
- Incorporate tariffs, cost savings initiative recording, and treatment protocol to ensure that all service providers adhere to the rules, and the tariff as guided by the RAF and / or any that is considered reasonable.
- Pre-authorise submitted claims
- Escalation of complex cases for multi-disciplinary review and adjudication.
- Participate in the consultations process on the implementation of medical claims processes.
- Relevant 3 years experience in a Medical related environment
- Claims management process/ processes and systems.
- Medical product management
- Medical bill reviewing
- Medical case management
- Complex problem identification, solving and decision making
- Customer value proposition
- Strong clinical analytical capabilities
- Knowledge of motor vehicle accident legislation
- Planning, Organising and Coordinating.
- Personal Mastery.
- Judgement and Decision Making.
- Ethics and Values.
- Client Service Orientation.
However, please keep a lookout on our website, for available positions which may be inline with your career aspirations.
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Job Detail
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Job IdJD1388210
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IndustryNot mentioned
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Total Positions1
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Job Type:Full Time
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Salary:Not mentioned
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Employment StatusPermanent
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Job LocationJohannesburg, Gauteng, South Africa
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EducationNot mentioned