Brooklyn
Market related
Job Title: Case Manager - Medical Aid
Location: Tshwane Metro, Pretoria,
Insurance
Secondary Industry: Health, Medical and related
Job Duties:
- Plan and optimise
admission
- Inform family regarding short-term medical benefits and educate them regarding general care
document all relevant information
- Communicate clinical funding recommendations via hospital authorisation
skills
- Knowledge of hospital procedures and medical terminology
Preferred Qualifications:
Additional
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Brooklyn
market related
hours
Primary Industry:
Health, Medical and related
Secondary Industry:
urance
Job Duties:
- Perform clinical interventions including Drug Utilisation Review
application escalations to the Clinical Committee for cases outside of clinical protocols
- Load medicine
centre 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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Brooklyn
market related
hours
Primary Industry:
Health, Medical and related
Secondary Industry:
(SAPC)
Job Duties:
- Perform clinical interventions including Drug Utilisation Review
application escalations to the Clinical Committee for cases outside of clinical protocols
- Load medicine
centre 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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Brooklyn
market related
hours
Primary Industry:
Health, Medical and related
Secondary Industry:
ance
Qualifications:
A relevant clinical or business related ND or Bachelor degree
directives
Utilise data analytical tools to assess network performance, identify trends, and make data-driven d
ensures adherence to company policies. They utilise data analytical tools to assess network performance,
provider network management, within the context of medical schemes or health insuranceKnowledge and
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Brooklyn
Market related
Full-Time
Primary Industry:
Health, Medical and related
Secondary Industry:
out member and supplier data analyses and forecasting
Improve the data warehouse reports in conjunction
conjunction with the BI departmentCollect data from relevant sources and perform actuarial analyses
experienceReview demographics and financial claims data on a monthly basisMonitor, analyse, and
regarding specific subsetsAnalyse hospital data on utilisation and alternative reimbursement model
share this job on whatsapp
Brooklyn
Market related
Full-Time
Primary Industry:
Health, Medical and related
Secondary Industry:
out member and supplier data analyses and forecasting
Improve the data warehouse reports in conjunction
conjunction with the BI departmentCollect data from relevant sources and perform actuarial analyses
experienceReview demographics and financial claims data on a monthly basisMonitor, analyse, and
regarding specific subsetsAnalyse hospital data on utilisation and alternative reimbursement model
share this job on whatsapp
Brooklyn
Market related
Full-Time
Primary Industry:
Health, Medical and related
Secondary Industry:
out member and supplier data analyses and forecasting
Improve the data warehouse reports in conjunction
conjunction with the BI departmentCollect data from relevant sources and perform actuarial analyses
experienceReview demographics and financial claims data on a monthly basisMonitor, analyse, and
regarding specific subsetsAnalyse hospital data on utilisation and alternative reimbursement model
share this job on whatsapp
Brooklyn
market related
expereince of systems and processes used in the medical aid or insurance industry
Knowledge and
share this job on whatsapp
Brooklyn
market related
expereince of systems and processes used in the medical aid or insurance industry
Knowledge and
share this job on whatsapp