Manager: External Stakeholder Support (Medical Doctor) Medical Scheme Pretoria KPAsü Manage the administrative function in the Medical Advisory Services business unitü Contribute to and conduct targeted research into local and international clinical guidelines andfunding policies.ü Critical review and analysis of current cost drivers and trends and compare with those of local andinternational sources for best practice.ü Assist in the management and monitoring of clinical cost targetsü Assist in developing and maintaining adequate knowledge of data handling and interpretation of informationtranslating interventions.ü Chair and coordinate monthly SPN meetingsü Perform Service Level Agreement quarterly site visitsü Support in the management and monitoring of SPNs to implement and give results within set targetsü Support in the management of divisional budget in line with budget allocationü Assist in improving member valueü Monitor project/programme in conjunction with the internal Project Management Unit of the Schemeü Ensure that all relevant projects are carried out and finalisedü Liaise with SPNs on operational mattersü Represent the Healthcare Management Division at SPN and External Stakeholder Engagements,including but not limited to Schemes Provider Summits, industry conferences, member Makgotlas,SAPS, BHF, DPSA, various other external stakeholdersü Represent the Healthcare Management in external stakeholder eventsü Assist in the process for development and maintenance of Medical Advisory Services standard operatingprocedures and policies.ü Assist the Medical Advisory Services in providing clinical support to Healthcare Management andthe Schemes other divisions in their external stakeholder-related mattersü Support Provider Relations and Network engagements (quarterly hospital efficiency, provider society andgroups and other forums as required).ü Clinical review of hospital and provider efficiency and network reports.ü Advise the Scheme on existing and new alternative reimbursement models received from externalstakeholders Requirements ü Minimum MBChB/ MBBCh. Must be registered with the HPCSAü Qualifications in Health Technology Assessment or Evidence-Based Medicine would be advantageousü At least five (5) years work experience in the healthcare funding / medical scheme industry with at leasttwo (2) years at manager/supervisor levelü Experience in the evaluation of health technology assessments would be advantageousü Must have experience in the development and presentation of management reportsü A good understanding of coding (Nappi, Tariffs, ICD10, CPT4, UPFS and moreü A good understanding of the South African Healthcare Industryü A good understanding of the Medical Schemes Actü The ability to conduct research using a variety of academic and market-related resources Desirable Sound understanding of the medical schemes industry
