Senior Manager Clinical Consulting Services

Oversee the functioning of the Clinical Consulting Services subdivision by managing the subdivision projects and day today function of the Clinical unit including performance management development and implementations of operational

plans.

Facilitate clinical support to other subdivision such as Benefits Management Research & Monitoring Legal Services etc.

Coordinating and participating in the development of Prescribed Minimum Benefit definition and review:

• Participate in the development of PMB definition and review by applying a combination of clinical financial and health
  

  economic skills.
  

• Support the analysis of Scheme Risk Measurement with epidemiological input (analyses and interpretation of disease
  

  trends and costs.
  

Adjudication of clinical opinions:

• To oversee the provision of evidence based quality and meticulous clinical opinions.
  

• To provide feedback on clinical enquiries and opinions to external stakeholders.
  

Coordinate Clinical Review Committee:

• To coordinate clinical review committee meetings monitor report and manage Clinical Review Committee (CRC)
  

  activities.
  

• To participate in the appeals committee and provide clarity to the appeal committee on clinical opinions that informs rulings.
  

Provide support to National Department of Health:

• To attend meetings and provide inputs to National Department of Health committees related to CMS work.
  

• To implement adhoc national health policy projects and provide policy directive.
  

Undertake assignments/tasks allocated by line manager in accordance with operational requirements.

SKILLS AND KNOWLEDGE BASE

The successful candidate will have the following essential qualifications competencies and skills:

Bachelor of Medicine and Bachelor of Surgery (MBChB) or a degree in Medicine with post graduate training in Epidemiology

and Public Health at NQF level 8;

Masters degree qualification in Public Health will be an added advantage;

Completed Internship and Community service;

A valid Health Professional Council of South Africa (HPCSA) Certificate; and

A minimum of 12 years experience in the Medical Schemes and/or Healthcare environment of which 5 years must be in

Knowledge of related legislation impacting on and influencing the functioning of the organisation (MSA PFMA CPA Constitution etc);

Knowledge of public health and health care industry;

Good knowledge of medical system and health management and clear understanding of the health policy implementation

landscape;

Stakeholder management;

Understanding of information management;

Understanding community challenges and opportunities relating to the mission of the organization; and

Computer Literacy.

Technical/professional knowledge and proficiency.

Policy development maintenance and implementation.

Strategic Management (decision making planning analysis and implementation);

Financial management;

Risk project and programme management;

Communication interpersonal and presentation;

Leadership and people management skills (mentoring and coaching).

Problem definition analysis and decision making.

The total annual package for the position is R.00