Manager: Tariffs and Billing Rules - City Of Tshwane Metro Verfied

R 850000 per annum City Of Tshwane Metro, Gauteng City Of Tshwane Metro, Gauteng more than 14 days ago 19-08-2019 10:36:42 AM
14-10-2019 10:36:42 AM
Manage the entire tariff file; and the entire Billing Rules Manual; Manage and evaluates service levels of the scheme’s managed care service providers in relation to tariffs and billing rules on a monthly and quarterly basis; Produces a report on all engagement between the Division and providers (i.e. healthcare; and non-healthcare service providers) with regards to tariffs management and clinical coding; Manages and monitors tariffs and clinical coding on monthly and quarterly basis; Manage and support the implementation of ARMs; Supports in rolling out hospital network in accordance with approved programme and in line with the approved tariff rate by BoT; Ensures timeous submission of all tariff, clinical coding and ARM reports from SPNs; Manages the implementation of the full and final settlement agreements with regards to matters relating to tariff, clinical coding and ARMs; Ensures that the engagements with hospital groups, pathologists and other healthcare providers on tariffs, tariff increases and/or negotiated rates conducted in accordance with the approved Provider Relationship Strategy;

Deg/Dipl or equivalent NQF Level in Clinical Sciences (medical/ nursing/ physiotherapy/psychology etc.); A post graduate qualification will be advantageous; At least 6-8years functional experience in the healthcare funding/ or medical Scheme industry; Be a subject matter expert or specialist in tariff and billing rules field; Be organised and have good time management skills;