This role develops and implements compliant benefits to provide optimal healthcare services to members in a financially sustainable manner. It develops and implements effective, data analytics-driven, evidence-based healthcare delivery strategy to deliver optimal healthcare provision coverage and health outcomes. The role identifies opportunities for optimisation of healthcare costs, whilst ensuring delivery of quality healthcare services to members; and monitors implementation of healthcare provision including risk assessment, managed care and clinical support programmes, and provider networks. The role executes effective clinical governance and clinical audit practices.Minimum Requirement:MBCHBRegistration with the HPCSA8 years' experience in Clinical Services in medical schemes6 years management experienceDemonstrate deep knowledge of medical scheme clinical systems.
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