Job Description

Manager: External Stakeholder Support (Medical Doctor) - Medical Scheme - PretoriaPOSITION INFO:Manager: External Stakeholder Support (Medical Doctor) xe2x80x93 Medical Scheme xe2x80x93 PretoriaKPAsxc3xbc Manage the administrative function in the Medical Advisory Services business unitxc3xbc Contribute to and conduct targeted research into local and international clinical guidelines andfunding policies.xc3xbc Critical review and analysis of current cost drivers and trends and compare with those of local andinternational sources for best practice.xc3xbc Assist in the management and monitoring of clinical cost targetsxc3xbc Assist in developing and maintaining adequate knowledge of data handling and interpretation of informationtranslating interventions.xc3xbc Chair and coordinate monthly SPN meetingsxc3xbc Perform Service Level Agreement quarterly site visitsxc3xbc Support in the management and monitoring of SPNs to implement and give results within set targetsxc3xbc Support in the management of divisional budget in line with budget allocationxc3xbc Assist in improving member valuexc3xbc Monitor project/programme in conjunction with the internal Project Management Unit of the Schemexc3xbc Ensure that all relevant projects are carried out and finalisedxc3xbc Liaise with SPNs on operational mattersxc3xbc Represent the Healthcare Management Division at SPN and External Stakeholder Engagements,including but not limited to Schemexe2x80x99s Provider Summits, industry conferences, member Makgotlas,SAPS, BHF, DPSA, various other external stakeholdersxc3xbc Represent the Healthcare Management in external stakeholder eventsxc3xbc Assist in the process for development and maintenance of Medical Advisory Services standard operatingprocedures and policies.xc3xbc Assist the Medical Advisory Services in providing clinical support to Healthcare Management andthe Schemexe2x80x99s other divisions in their external stakeholder-related mattersxc3xbc Support Provider Relations and Network engagements (quarterly hospital efficiency, provider society andgroups and other forums as required).xc3xbc Clinical review of hospital and provider efficiency and network reports.xc3xbc Advise the Scheme on existing and new alternative reimbursement models received from externalstakeholdersRequirementsxc3xbc Minimum MBChB/ MBBCh. Must be registered with the HPCSAxc3xbc Qualifications in Health Technology Assessment or Evidence-Based Medicine would be advantageousxc3xbc At least five (5) years work experience in the healthcare funding / medical scheme industry with at leasttwo (2) years at manager/supervisor levelxc3xbc Experience in the evaluation of health technology assessments would be advantageousxc3xbc Must have experience in the development and presentation of management reportsxc3xbc A good understanding of coding (Nappi, Tariffs, ICD10, CPT4, UPFS and morexc3xbc A good understanding of the South African Healthcare Industryxc3xbc A good understanding of the Medical Schemes Actxc3xbc The ability to conduct research using a variety of academic and market-related resourcesDesirableSound understanding of the medical schemes industrySimilar jobs you might be interested in:Location: Pretoria
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