Clinical Risk Network Manager - Randburg Verfied

R 700k per annum Randburg, Gauteng Randburg, Gauteng more than 14 days ago 19-04-2019 9:02:06 PM
14-06-2019 9:02:06 PM
PURPOSE OF THE POSITION

- Accountable for the provision of specialist knowledge, delivery plans and associated practices to minimize the Scheme’s financial risk by developing and maintaining key relationships with health provider networks. This role is also accountable for identifying and implementing the roll out of the approved and suitable Scheme health provider networks in line with the Clinical Risk strategy

KEY PERFORMANCE AREAS

The following Key Performance Areas are applicable:
- Analyse and identify gaps in the Scheme’s current network arrangement and put a plan to mitigate and close the identified gaps, in line with the Clinical risk strategy.
- Develop a plan, implement, manage and monitor a return on investments of the recommended and/or approved networks.
- Develop, implement and manage provider contracting to include provider recruitment, contract negotiation, provider education and problem resolution.
- Develop and implement provider network management projects and ensure adequate feedback on the project status.
- Coordinate and facilitate end-to-end project management principles for multiple projects and provide updates accordingly, to the relevant stakeholders.
- Accountable for the mitigation of the department’s risk profile as well as implementing sound governance and compliance processes to identify and manage risk, in the management of the function.
- Ensure that all contracts are accurate and concluded timeously, in consultation with the legal department.
- Support and provide evidence of all audit requirements as required by internal and external audit Service Provider.
- Continuous evaluation and monitoring of providers performance standards.
- Accountable for providing input in the planning and compilation of the department’s annual budget aligned to delivery plans to support the implementation of set objectives.

MINIMUM JOB REQUIREMENTS

Qualifications
- B Degree or Diploma in Health related field

Experience
- A minimum of 3 – 5 years in a similar role, in a contact centre Environment OR
- 3 – 5 years in an Operational environment at a Managerial level

KNOWLEDGE, SKILLS AND ATTRIBUTES

1. Knowledge
- Clinical
- Healthcare
- Contracting
- Reimbursement methodologies

2. Skills
- Oral & written communication
- Customer service
- Analytical thinking
- Decision making
- Planning & Organising
- Innovation
- Problem solving
- Networking.
- Team orientation
- Excellent presentation skills
- Skilled negotiator

3. Attributes
- Building collaborative relationships
- Diagnostic information gathering
- Initiative
- Fostering innovation
- Self confidence
- Team work
- Managing performance

CLOSING DATE: 24 April 2019