Brooklyn
market related
Job Title: Specialist Network Manager
Location:
Tshwane Metro, Pretoria, Brooklyn
Job
Qualifications:
A relevant clinical or business related ND or Bachelor degree
Skills:<
claims monitoring process
Evaluate the performance of healthcare providers to ensure adherence to
ise data analytical tools to assess network performance, identify trends, and make data-driven decis
decisionsPrepare regular reports on key performance indicators and present findings to leadership
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Brooklyn
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Job Title: Case Manager - Medical Aid
Location: Tshwane Metro, Pretoria,
turnaround time
Follow up on long-term and high-cost cases of hospitalised and home care patientsIdentify
of cases that require input from management or the teamManage telephonic calls and inquiries from
support staffIdentify and manage complicated and high-cost cases that have a financial impact
Knowledge and Skills:
Brooklyn
market related
Medihelp to execute the strategy
Develop cost reduction frameworksEvaluate processes
information from a variety of sources to inform business process mapping and documentationIdentify
BPM softwareManage process improvement requirements and ensure that business needs and decisions
decisions are storedTranslate business analysts and business units discussions into process maps and
proceduresFacilitate Kaizen sessions with business and team membersInvestigate system and
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Brooklyn
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in Industrial Engineering, or A certificate in Business or Process Analysis
Skills:
Brooklyn
Market related
department
Collect data from relevant sources and perform actuarial analyses modelling and reporting as
utilisation and alternative reimbursement model performanceEnsure the compilation of all annexures
Legislative and regulatory prescripts, Enterprise risk management frameworks, Medihelp policies guidelines and
ee years relevant experience in managed care, health risk management, service/product pricing, or scheme
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Brooklyn
Market related
department
Collect data from relevant sources and perform actuarial analyses modelling and reporting as
utilisation and alternative reimbursement model performanceEnsure the compilation of all annexures
Legislative and regulatory prescripts, Enterprise risk management frameworks, Medihelp policies guidelines and
ee years relevant experience in managed care, health risk management, service/product pricing, or scheme
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Brooklyn
market related
Industry:
Insurance
Job Duties:
- Perform clinical interventions including Drug Utilisation
and doctors
- Manage operational and clinical tasks within Medicine Management
Required
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Brooklyn
Market related
department
Collect data from relevant sources and perform actuarial analyses modelling and reporting as
utilisation and alternative reimbursement model performanceEnsure the compilation of all annexures
Legislative and regulatory prescripts, Enterprise risk management frameworks, Medihelp policies guidelines and
share this job on whatsapp
Brooklyn
market related
Council (SAPC)
Job Duties:
- Perform clinical interventions including Drug Utilisation
and doctors
- Manage operational and clinical tasks within Medicine Management
Required
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