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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