Brooklyn
market related
Job Title: Specialist Network Manager
Location:
Tshwane Metro, Pretoria, Brooklyn
Job
develop educational materials for members
Manage budget and ensure no deviationsEnsure
workJob Duties:
The Specialist Network Manager is responsible for identifying, evaluating, and
regulatory compliance. The Specialist Network Manager serves as a primary point of contact for providers
members. Additionally, the Specialist Network Manager manages the budget, ensures operational efficiency
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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
and complicationsNegotiate within the scheme rules regarding tariffs and discountsIdentify
relevant informationCommunicate clinical funding recommendations via hospital authorisation notes
staffIdentify and manage complicated and high-cost cases that have a financial impact on the schemeRequired
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Brooklyn
Market related
compilation of all annexures for the Council for Medical Schemes relating to members
Compile annual utilisation
Legislative and regulatory prescripts, Enterprise risk management frameworks, Medihelp policies guidelines and
experience in managed care, health risk management, service/product pricing, or scheme benefit design/healthcare
designing value-added products within the medical scheme environment, along with MS SQL programming ski
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Brooklyn
Market related
compilation of all annexures for the Council for Medical Schemes relating to members
Compile annual utilisation
Legislative and regulatory prescripts, Enterprise risk management frameworks, Medihelp policies guidelines and
experience in managed care, health risk management, service/product pricing, or scheme benefit design/healthcare
and designing value-added products in the medical scheme environment, along with MS SQL programming ski
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Brooklyn
market related
and doctors
Manage operational and clinical tasks within Medicine ManagementRequired
accuracy
Knowledge of The Pharmacy Act, the Medical Scheme Act, Pharmacology, PMB and algorithms for ICD
share this job on whatsapp
Brooklyn
market related
and doctors
Manage operational and clinical tasks within Medicine ManagementRequired
accuracy
Knowledge of The Pharmacy Act, the Medical Scheme Act, Pharmacology, PMB and algorithms for ICD
share this job on whatsapp
Brooklyn
Market related
compilation of all annexures for the Council for Medical Schemes relating to members
Compile annual utilisation
Legislative and regulatory prescripts, Enterprise risk management frameworks, Medihelp policies guidelines and
share this job on whatsapp
Brooklyn
market related
automation opportunities using BPM software
Manage process improvement requirements and ensure that
share this job on whatsapp
Brooklyn
market related
automation opportunities using BPM software
Manage process improvement requirements and ensure that
share this job on whatsapp