Brooklyn
          
 market related          
                                                
Job Title: Specialist Network Manager
Location:
Tshwane Metro, Pretoria, Brooklyn
Job
                        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
                        develop educational materials for membersManage budget and ensure no deviationsEnsure
                                                
            
          
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Brooklyn
          
 Market related          
                                                
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
                        members, and support staffIdentify and manage complicated and high-cost cases that have a financial
                        Knowledge and 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
                                                
            
          
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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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Brooklyn
          
 market related          
                                                automation opportunities using BPM software
Manage process improvement requirements and ensure that
                                                
            
          
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Brooklyn
          
 market related          
                                                automation opportunities using BPM software
Manage process improvement requirements and ensure that
                                                
            
          
 share this job on whatsapp