Medical Aid Disease Management Co Ordinator – Bryanston – R26 to R30 000.00

We have a new exciting opportunity available at this medical aid organisation based in Bryanston. The successful candidate would need to be organised , a strategic thinker as well as a strong communicator. Excellent working environment and great opportunity for growth both personally and professionally.

Responsibilities
? Assist in developing a comprehensive wellness / disease management programme
? To develop a method and agree with the funder / employer how to manage and operationalise beneficiary disease registrations and reimbursement
? Maintain the chronic medication benefit rules, registration and compliance reporting
? Ensure an optimal interface with the PBM provider to facilitate beneficiary registrations for listed chronic medicine programs
? Coordinate services by contracted providers to deliver annual wellness screenings and services for example health days
? Liaise with service providers to enable evidence-based service delivery
? Liaise with enrolled members to ensure adequate funding and compliance to a Care-map
? Develop monthly and other reporting to stakeholders
? Ensure efficient Customer Service and compliance to agreed SLA’s
? Follow up with healthcare practitioners and members who may be over utilising the “in rooms” procedures.
? Manage and maintain data integrity and update accordingly where necessary.
? Ensure all enquiries are resolved satisfactorily and customer requirements within business rules and costing factors are maintained.
? Any other duties as assigned by your supervisor from time to time.

Requirements
? At least 5 years’ experience as a registered Pharmacy Assistant
? Matric
? Registered pharmacy assistant
? Valid membership of the South African Pharmacy Council
? MIP Application System experience an advantage but not essential.
? Sound understanding of the South African Health Industry
? Ability to liaise with external parties – clinicians and members
? Ability to work within an established team
? Excellent oral and written communication skills
? Customer centric attitude
? Excellent analytical skills and pays attention to detail
? Computer literate - MS Office suite, i.e. proficient in Excel
? Good understanding of evidence-based medicine principles and embracing health economic principles and tools.
? Good understanding of the principles of healthcare funding design will be an advantage.