Consultant Medical Management - 3 year Fixed Term Contract

Recruiter:

Six Sense Consulting

Job Ref:

JHB001164/AK

Date posted:

Monday, December 9, 2024

Location:

Centurion, South Africa

Salary:

Annually

SUMMARY:
A well-established financial services business is seeking to appoint a Consultant Medical Management on a 3 year Fixed Term Contract

Purpose of the job: The Consultant: Medical Management is responsible to implement the medical management activities, medical exception handling and providing administration support in claims
processing.

POSITION INFO:
Qualifications and Experience:

Bachelor’s Degree/Advanced Diploma in Health Sciences /Medical related qualification.
Registration with HPCSA/SANCA
Relevant 3 years’ experience in a Medical related environment
Conduct medical assessment and compile injury assessment reports.
Conduct assessments and bill reviews on submitted claims, focusing on the appropriate level of care, the length of stay, and quality of care.
Escalation of complex cases for multi-disciplinary review and adjudication.
Participate in the consultations process on the implementation of medical claims processes.

Technical Competencies:

Claims management process/ processes and systems.
Medical product management
Medical bill reviewing
Medical case management
Complex problem identification, solving and decision making Customer value proposition
Strong clinical analytical capabilities
Knowledge of motor vehicle accident legislation
Planning, Organising and Coordinating.
Personal Mastery.
Judgement and Decision Making.
Ethics and Values.
Client Service Orientation.

Please note that if you have not received a response within 14 days of submitting your application that your application was unsuccessful.
However, please keep a lookout on our website, for available positions which may be inline with your career aspirations.

NB! This job is now closed. You can apply for other jobs by uploading your CV.

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