Medical Advisory – Orthotics/ Prosthethics

Position: Medical Advisory: Orthotist/ Prosthetist Location: Cape Town Type: Hybrid/ Permanent Ref: MVG/ORPR Large Managed Care administrator seeks to employ a suitably qualified Orthotist/ Prosthetist with at least 4 years Managed Care experience for their Medical Advisory division. The core purpose of the role is to protect the scheme from over-utilization and inappropriate claims by service providers, safeguarding member and scheme funds.
Key requirements and responsibilities: Provide clinical input on funding requests Resolve clinical queries and assessments Implement solutions using departmental systems Offer recommendations to enhance efficiency and quality Identify issues and propose solutions Provide operational support for specialization Assess high-risk or high-cost procedures for appropriate authorization Provide clinical training and support Offer medical advisory services to internal and external stakeholders Ensure annual CPD is kept up to date Provide input support for specialist projects Engage with network providers Qualified Orthotist/ Prosthetist registered with HPCSA (Bachelor of Health Sciences in Medical Orthotics and Prosthesis) At least 4 years Managed Care experience or Private experience with working knowledge of ICD 10 Coding/ NAPPI Codes (Essential) Apply now by sending your CV and supporting documents to ******. Supporting documents: Copy of Comprehensive CV detailing relevant experience Copy of HPCSA Certification Copy of Degree Copy of Post Basic qualifications (if any)

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