Job Title: Specialist Network Manager

Location:

Tshwane Metro, Pretoria, Brooklyn

Job contracts with associated remuneration tiers and service level agreements
Collaborate with legal develop educational materials for members
Manage budget and ensure no deviations
Ensure work

Job 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

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Job Title: Case Manager - Medical Aid

Location: Tshwane Metro, Pretoria, and optimise daily tasks to update cases on the hospital list within the 8-hour turnaround time

Follow patients

Identify the need for patient and hospital visits where possible and give documented fee of cases that require input from management or the team

Manage telephonic calls and inquiries from from all clients and service providers

Co-ordinate services and care for members to prevent re-admissions

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Senior Actuarial Analyst

Brooklyn

Market related

utilisation regarding specific subsets

Analyse hospital data on utilisation and alternative reimbursement Legislative and regulatory prescripts, Enterprise risk management frameworks, Medihelp policies guidelines and years relevant experience in managed care, health risk management, service/product pricing, or scheme benefit

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Senior Actuarial Analyst

Brooklyn

Market related

utilisation regarding specific subsets

Analyse hospital data on utilisation and alternative reimbursement Legislative and regulatory prescripts, Enterprise risk management frameworks, Medihelp policies guidelines and years relevant experience in managed care, health risk management, service/product pricing, or scheme benefit

share this job on whatsapp

Senior Actuarial Analyst

Brooklyn

Market related

utilisation regarding specific subsets

Analyse hospital data on utilisation and alternative reimbursement Legislative and regulatory prescripts, Enterprise risk management frameworks, Medihelp policies guidelines and

share this job on whatsapp