Job title : Chief Healthcare Officer REF: GEMS01102024 Job Location : Gauteng, Pretoria Deadline : December 05, 2024 Quick Recommended Links Jobs by Location Job by industries Key Performance Areas (KPAs) Develop, implement and maintain the Scheme's overarching clinical strategies that align with organisational goals.
Oversee the Scheme's clinical function and integrate evidence-based clinical funding guidelines to ensure best practice.
Oversee the Scheme's Networks and Provider Relations Strategies, as well as the Scheme's Provider Relations Officer (PLO) Programme strengthen stakeholder relationships and encourage collaboration and innovation.
Develop and execute strategies to build and maintain robust healthcare networks, including hospitals, primary care, and specialist providers.
Develop and implement comprehensive strategies for managing tariffs and billing rules aligned with organisational goals.
Progressively implement the Scheme's strategy on the implementation of Alternative Reimbursement Arrangements (ARM) with all hospital groups.
Develop and implement policies for effective management of the Scheme's medicine formularies and exclusion lists.
Oversee the implementation and management of value-based active disease risk management initiatives, with the aim of improving patient outcomes.
Oversee the development of the Scheme's annual comprehensive sourcing strategies aligned with organisational goals.
Maintain oversight of the Scheme's managed care function and ensure that all contracted service provider network (SPN) functions and ensure compliance to Service Level Agreements (SLA).
Foster strong relationships with healthcare providers to support strategic goals and initiatives, while utilising feedback from providers to inform decision-making and improve service deliver Qualification requirements are: Postgraduate (NQF Level 8) MBCHB or equivalent in a related field/ Honours/ Professional Qualifications Strong understanding of the South African Healthcare and Medical Scheme Industry Twelve years (12) of functional experience with at least five to eight years (5-8) in a highly strategic Medical Scheme / Managed Healthcare Senior Management role including staff supervisory, budgetary, and management responsibility.
Desirable Master/ Postgraduate degree in Health Economics or Business Management Medical / Healthcare jobs