Senior Manager: Clinical Consulting Services
Krypton Mining, South Africa

We are seeking a highly qualified and experienced Senior Manager to oversee our Clinical Consulting Services department. The successful candidate will play a pivotal role in ensuring the provision of clinical services, administering the Prescribed Minimum Benefits (PMB) portfolio, and developing and implementing the Prescribed Minimum Benefits regulation strategy. As a Senior Manager, you will lead a dedicated team to drive the implementation of planned activities and projects, ensuring the protection and guarantee of medical scheme members' entitlements.

Key Responsibilities:

• Oversee the functioning of the Clinical Consulting Services sub-division, managing projects and day-to-day operations, including performance management, development, and implementation of operational plans.
• Facilitate clinical support to other sub-divisions such as Benefits Management, Research amp; Monitoring, Legal Services, etc.
• Coordinate and participate in the development and review of Prescribed Minimum Benefit definitions, applying a combination of clinical, financial, and health economic skills.
• Adjudicate clinical opinions, ensuring the provision of evidence-based, quality, and meticulous clinical opinions.
• Coordinate Clinical Review Committee activities, including meetings, monitoring, reporting, and managing committee activities.
• Provide support to the Department, attending meetings and providing input, and implementing ad-hoc national health policy projects.
• Undertake assignments/tasks allocated by line manager in accordance with operational requirements.

Requirements

Skills and Knowledge Base:

• Bachelor of Medicine and Bachelor of Surgery (MBChB) or a degree in Medicine with post-graduate training in Epidemiology and Public Health at NQF level 8.
• Masters’ degree qualification in Public Health will be an added advantage.
• Valid Health Professional Council of South Africa (HPCSA) Certificate.
• Minimum of 12 years’ experience in the Medical Schemes and/or Healthcare environment, with 5 years in Evidence-Based Medicine amp; Clinical Management, and 7 years at Management/Supervisory level.
• Knowledge of related legislation impacting and influencing the functioning of the organization (MSA, PFMA, CPA, Constitution, etc.).
• Good knowledge of the public health and healthcare industry.
• Stakeholder management skills.
• Understanding of information management.
• Computer Literacy.

Job Rewards and Benefits