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Gauteng: Consultant Medical Management – 3 Year Contract posted by Six Sense Consulting

Consultant Medical Management – 3 Year Contract

Posted on 2025-02-10

Job Summary

Qualifications:

  • Bachelor’s Degree/Advanced Diploma in Health Sciences /Medical related qualification.
  • Registration with HPCSA/SANCA
  • Medical management
  • Conduct medical assessment and compile injury assessment reports.
  • Conduct assessments and bill reviews on submitted claims, focusing on the appropriate level of care, the length of stay, and quality of care.
  • Incorporate tariffs, cost savings initiative recording, and treatment protocol to ensure that all service providers adhere to the rules, and the tariff as guided by the RAF and / or any that is considered reasonable.
  • Pre-authorise submitted claims
  • Escalation of complex cases for multi-disciplinary review and adjudication.
  • Participate in the consultations process on the implementation of medical claims processes.

Experience:

  • Relevant 3 years’ experience in a Medical related environment
  • Claims management process/ processes and systems.
  • Medical product management
  • Medical bill reviewing
  • Medical case management
  • Complex problem identification, solving and decision making
  • Customer value proposition
  • Strong clinical analytical capabilities
  • Knowledge of motor vehicle accident legislation
  • Planning, Organising and Coordinating.
  • Personal Mastery.
  • Judgement and Decision Making.
  • Ethics and Values.
  • Client Service Orientation.

Please note that if you have not received a response within 14 days of submitting your application that your application was unsuccessful.
However, please keep a lookout on our website, Six Sense Consulting
Consultant Medical Management – 3 Year Contract position available in Gauteng, Gauteng. This job position was posted by Six Sense Consulting. The job has been posted as a char8000 ad on 2025-02-10 at 01:04:11 in the Insurance And Investments category

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