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
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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
members, and support staffIdentify and manage complicated and high-cost cases that have a financial
Knowledge and Skills:
Brooklyn
Market related
supplier data analyses and forecasting
Improve the data warehouse reports in conjunction with
departmentCollect 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
supplier data analyses and forecasting
Improve the data warehouse reports in conjunction with
departmentCollect 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
share this job on whatsapp
Brooklyn
Market related
supplier data analyses and forecasting
Improve the data warehouse reports in conjunction with
departmentCollect 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
/p>
Skills:
- Identify process improvement areas within Medihelp to execute the strategy
- Develop
industry best practises and identify areas of improvement
- Gather and analyse information from a
opportunities using BPM software
- Manage process improvement requirements and ensure that business
changes to reduce lead-time, improve quality, reduce risk. and improve process and system efficiency
Skills:
Extensive knowledge of process improvement methodologies, strong analytical skills, ability
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Brooklyn
market related
Analysis
Skills:
- Identify process improvement areas within Medihelp to execute the strategy
- Develop
industry best practises and identify areas of improvement
- Gather and analyse information from a
opportunities using BPM software
- Manage process improvement requirements and ensure that business
changes to reduce lead-time, improve quality, reduce risk. and improve process and system efficiency
Skills:
Extensive knowledge of process improvement methodologies, strong analytical skills, ability
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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
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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