Executive : Managed Healthcare

Pps; Gauteng; On-site; ZAR 900,000 - 1,500,000; Full time

Job summary

A leading healthcare organization is seeking an outstanding leader to support the CEO in enhancing products and services for medical aid scheme members. This role focuses on developing operational strategies, managing healthcare targets, and building stakeholder relationships, targeting candidates with executive experience in healthcare management. The successful candidate will drive profitability and ensure compliance with industry standards.

Qualifications

• 3 - 5 years of executive management experience.
• Proven success in managed healthcare environment.
• Knowledge of contractual agreements and legal considerations.
• Experience in clinical protocol development.

Responsibilities

• Develop and implement operational strategies.
• Monitor and improve operational activities.
• Manage and develop staff.
• Establish performance measurement systems.
• Control organizational expenditure.

Skills

Strategic planning

Business development

Data analysis

Leadership skills

Interpersonal skills

Problem-solving

Education

Membership in professional medical bodies

Tools

MS Office

Job description

We are looking for an outstanding leader to support the CEO by providing strategic direction aimed at enhancing the organization's products and services for members of medical aid schemes.

The role involves ensuring the organization is a key player in managed healthcare services through strong stakeholder relationships. The candidate will manage the achievement of all managed healthcare targets within the full spectrum of services sought by clients in the health insurance market.

They will also develop innovative managed healthcare solutions within the industry and contribute to increasing the organization's profitability by planning, organizing, leading, and controlling operations while maintaining existing business.

Requirements

• 3 - 5 years of executive management experience is essential.
• Proven success in a corporate managed healthcare environment is advantageous.
• Knowledge of contractual agreements and legal considerations is beneficial.
• Membership in professional medical bodies (e.g., SAMA, SAPC, SANC) is preferred.
• Knowledge of the Medical Schemes Act No. is advantageous.
• Experience in clinical protocol development and disease management is essential.

Knowledge and Skills

• Strategic planning and business development skills.
• Ability to manage processes and people to meet strategic objectives.
• Awareness of industry trends and competitor developments.
• Data analysis and performance metrics understanding.
• Proficiency in IT / Business infrastructure and MS Office.

Competencies

• Outstanding organizational and leadership skills.
• Excellent interpersonal and public speaking abilities.
• Strong decision-making and problem-solving skills.
• Proven leadership and management capabilities.
• Understanding of financial and economic concepts with the ability to identify opportunities.
• Market awareness and strategic decision-making skills.
• Ability to evaluate and adapt organizational strategy for future viability.

Duties and Responsibilities

• Develop and implement operational strategies to meet performance and budget goals across various areas such as clinical risk, disease management, preauthorization, case management, wellness programs, and underwriting.
• Establish systems to measure operational performance.
• Monitor, report, and improve operational activities.
• Manage and develop staff.
• Control organizational expenditure within budgets.
• Collaborate with other managers to align operational development with organizational needs.
• Ensure understanding and implementation of organizational strategy.
• Contribute to strategic evaluation and performance improvement.
• Identify opportunities for business growth and client acquisition.
• Build profitable relationships with clients.
• Ensure compliance with quality, safety, legal, and environmental standards.
• Act ethically as a company director according to PPS Healthcare's Code of Ethics.
• Stay informed about competitor activities and market trends.
• Deliver high standards of customer service to enhance retention and referrals.
• Assist in product development and benefit design for medical schemes.
• Manage core product diversification efforts.
• Support the Principal Officer in care coordination and managed care for scheme members.