Senior Manager: Healthcare Strategy – Pretoria – 6 Months Contract

JOB SUMMARY
As a Senior Manager Healthcare Management you will be required to support the Executive in Healthcare Management in: Managing the Scheme’s clinical risk profile and claims experience, and
Assess and mitigate risks.

Administration and Support
? Develop a framework and establish the Scheme’s community based healthcare initiatives
? Develop a strategy for the implementation of provider up-skilling and training as part of disease risk management
? Analytical review of the Scheme’s supply side reform initiatives
? Monitor and manage the research initiatives for mental health and environmental health initiatives
? Manage and monitor the implementation of the clinical governance toolkit
? Assist the CHMO to develop and build the Scheme’s internal capabilities for Provider Relations
? Assist the CHMO to develop and build the Scheme’s internal capabilities for Network Contract Management
? Support and participate in the Scheme’s Year End processes
? Provide healthcare support for the implementation of the Scheme’s new Networks
? Analyse and review of the SPN SLA’s and contracting for 2018
? Perform analytical review of the Scheme’s funding guidelines, managed care systems and processes
? Perform analytical review of new technological advances in healthcare
? Perform analytical review of the Scheme’s claims experience
? Support and participate in the Scheme’s Year End processes
? Provide strategic support to CHMO for all healthcare related initiatives in line with strategy
? Provide technical and strategic support for the Scheme’s participation in National Advisory committees

Budget, expenses and procurement
? Supports CHMO analysis of claims experience or claims trends, and ensuring that claims interventions are in line with budget allocation

Correspondence and documentation processes
? Reviews and approves stakeholder communication
? Maintain regular and scheduled communication with identified stakeholder group

Project management
? Manages the Healthcare Management Strategic Projects

Forums and Committees
? Supports Claims Management Forum and Working Groups
? Attends the Ex-Gratia Committee and makes recommendations
? Represents the Healthcare Management Division at SPN and stakeholder engagements

Technical expertise and application
? Apply sound programme and project management principles.
? Apply sound risk management principles
? Matured Business Acumen and communication skills
? Excellent analytical and strategic thinking

Staff Management Responsibility
? Manages staff career path and plans on an ongoing basis
? Assists in the development and implementation of the Division’s succession plans;
? Manages all the sub-ordinate’s grievances timeously
? Conducts performance reviews for all staff in the business unit and
? Ensures sound performance management implementation;
? Identifies areas of non-performance and recommends remedial measures in order to realise
? performance efficiencies

LIMITATIONS
? Scheme Policies and Procedures;
? Scheme Rules;
? Medical Schemes Act and Regulations;
? Directives from CHMO and EXCO; and
? Decisions of the Board of Trustees

LIAISON OPERATING ENVIRONMENT
? Chief Healthcare Management Officer
? Principal Officer, EXCO,
? Staff
? Contracted Service Provider Network (SPN) and Scheme’s stakeholders

Requirements
? Formal Qualification in Healthcare is essential.
? At least 10 years functional work experience in the Healthcare Funding industry and 5 years managerial experience;
? Ability to think and plan strategically
? Ability to work under pressure to agreed deadlines and adapt to change;
? Attention to detail to ensure high quality work levels:
? Must be in possession of a valid driver’s licence and own vehicle and be willing to travel at short notice.
? Ability to demonstrate highest level of ethical behaviour
? Excellent computer literacy and MS Office skills;
? Sound qualitative and quantitative analytical skills;
? Excellent communication writing skills and reporting skills;
? Sound planning / project management skills;
? Attention to detail; and
? Must be a self-starter
Desirable
? Experience in Clinical Risk Management
? Excellent Strategic Thinking
? Sound Clinical Knowledge hospital benefit management and healthcare networks management