Senior Specialist: Managed Care
Pretoria, Gauteng, South Africa
Job Description
Key Responsibilities:
- Analyse health data to stratify and segment member risk profiles.
- Develop condition- and category-based care plans and intervention strategies.
- Oversee healthcare risk management, including epidemic and chronic care response.
- Implement and evaluate preventative care, curative care, and wellness programmes.
- Manage hospital benefit interventions and ensure SLA targets are met.
- Lead managed care implementation monitoring and stakeholder engagement.
- Provide input on budgeting, forecasting, and cost control in managed care initiatives.
- NQF Level 7 Degree in Nursing or Health-related field.
- Minimum 6 years' experience in managed care.
- Demonstrated experience with:
- Health data analysis
- Care programme design
- Stakeholder management
- Budget and SLA performance monitoring
- Health Risk Assessment
- Analytical thinking
- Communication & Reporting
- Project and Financial Management
- Collaboration & Cultural Sensitivity
- Governance and Compliance
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Job Detail
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Job IdJD1462856
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IndustryNot mentioned
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Total Positions1
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Job Type:Full Time
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Salary:Not mentioned
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Employment StatusPermanent
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Job LocationPretoria, Gauteng, South Africa
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EducationNot mentioned