Permanent (10)

Job Title: Specialist Network Manager

Location:

Tshwane Metro, Pretoria, Brooklyn

Job ance

Qualifications:

A relevant clinical or business related ND or Bachelor degree

pate in the profiling process and meetings and assist with the claims monitoring process

Evaluate directives

Utilise data analytical tools to assess network performance, identify trends, and make data-driven d develop educational materials for members

Manage budget and ensure no deviations

Ensure

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Job Title: Case Manager - Medical Aid

Location: Tshwane Metro, Pretoria, of cases that require input from management or the team

Manage telephonic calls and inquiries from document all relevant information

Communicate clinical funding recommendations via hospital authorisation members, and support staff

Identify and manage complicated and high-cost cases that have a financial Knowledge and Skills:

Four years experience in Managed Healthcare with oncology and or experience in a

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Pharmacist Medicine Intervention

Brooklyn

market related

urance

Job Duties:

Perform clinical interventions including Drug Utilisation Review application escalations to the Clinical Committee for cases outside of clinical protocols
Load medicine and doctors
Manage operational and clinical tasks within Medicine Management

Required e:

Minimum of 2 years of experience in clinical interventions

Experience in the PBM environment

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Pharmacist Medicine Intervention

Brooklyn

market related

(SAPC)

Job Duties:

Perform clinical interventions including Drug Utilisation Review application escalations to the Clinical Committee for cases outside of clinical protocols
Load medicine and doctors
Manage operational and clinical tasks within Medicine Management

Required e:

Minimum of 2 years of experience in clinical interventions

Experience in the PBM environment Qualifications:

Postgraduate qualification in Clinical Pharmacy

Working Conditions:

Work

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Senior Actuarial Analyst

Brooklyn

Market related

out member and supplier data analyses and forecasting

Improve the data warehouse reports in conjunction conjunction with the BI department

Collect data from relevant sources and perform actuarial analyses analyses modelling and reporting as required

Assist in maintaining and developing processes to monitor experience

Review demographics and financial claims data on a monthly basis

Monitor, analyse, and regarding specific subsets

Analyse hospital data on utilisation and alternative reimbursement model

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Senior Actuarial Analyst

Brooklyn

Market related

out member and supplier data analyses and forecasting

Improve the data warehouse reports in conjunction conjunction with the BI department

Collect data from relevant sources and perform actuarial analyses analyses modelling and reporting as required

Assist in maintaining and developing processes to monitor experience

Review demographics and financial claims data on a monthly basis

Monitor, analyse, and regarding specific subsets

Analyse hospital data on utilisation and alternative reimbursement model

share this job on whatsapp

Senior Actuarial Analyst

Brooklyn

Market related

out member and supplier data analyses and forecasting

Improve the data warehouse reports in conjunction conjunction with the BI department

Collect data from relevant sources and perform actuarial analyses analyses modelling and reporting as required

Assist in maintaining and developing processes to monitor experience

Review demographics and financial claims data on a monthly basis

Monitor, analyse, and regarding specific subsets

Analyse hospital data on utilisation and alternative reimbursement model

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Creditors Clerk Brooklyn, Milnerton

The Talent Experts

South Africa

R15 000 - R25 000 per month

You'll play a crucial role in our finance team, managing accounts payable tasks with precision and efficiency Microsoft Excel to organize and analyse financial data, working closely with the team to uphold accuracy

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