Bachelors Degree/ Advanced Diploma in Health Sciences Nursing, Pharmacy related qualification.
Valid registration with the relevant Statutory body (SANC, SAPC, HPCSA etc).
Certification in evidence-based medicine and/or treatment protocol development will be an added advantage.
Relevant 5 - 7 years experience in a Managed Healthcare environment or similar in data sourcing, collection and navigation.
Experience working with treatment protocols and guidelines.
With experience working with medical databases, navigating large data quantities and data outputs.
With experience working with ICD 10 codes, CPT codes, NAPPI codes
Experience in Functional Capacity Evaluation and associated reports and tariffs applicable.
With experience working with coding systems (ICD 10, CPT and NAPPI codes).
Organize and Manage Health Information Data and Ensure its Quality, Accuracy, Accessibility and Security
Technical, Managerial, and behavioral competencies required
Communication.
Network and Alliances
Planning, Organising and Coordinating
Ethics and Values
Client Service Orientation
Change management
Conflict management
Policy conceptualisation and formulation
Risk Management
Knowledge of health data standards
Knowledge of managed healthcare or financial risk assessment principles (environment)
Knowledge of standards within the health industry
Knowledge and understanding of the RABS Bill and its benefits
Knowledge of the National Health Act, RAF Act, and other health related legislation such as the Medical Schemes Act, etc.
Please note that if you have not received a response within 14 days of submitting your application that your application was unsuccessful. However, please keep a lookout on our website, for available positions which may be in line with your career aspirations.
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