Legal Advisor - Talent Pool

Discovery Limited; Johannesburg; On-site; ZAR 400,000 - 600,000; Full time

Job summary

A leading company in healthcare innovation is seeking a Legal Advisor to join their Clinical Benefit Advisory Team. The successful applicant will manage legal disputes related to Discovery Health and provide comprehensive legal support. Responsibilities will include arguing cases at dispute hearings, drafting legal documents, and advising on legal matters pertaining to the Medical Schemes Act.

Qualifications

• At least 1 year working experience in the medical schemes environment.
• Proficient in Excel for basic computer literacy.
• Clinical/Medical knowledge is advantageous.

Responsibilities

• Manage legal disputes and provide legal assistance.
• Argue cases at Dispute Hearings and manage the Dispute Process.
• Assist in drafting heads of arguments and legal letters.

Skills

Excellent written and verbal communication

Knowledge of Managed Care Environment

Drafting legal documents

Education

LLB qualification

Matric

Tools

Microsoft Office

Job description

Clinical Benefit Advisory Team

Legal Advisor

About Discovery

Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders, Discovery is passionate about innovating in order to not only achieve financial success, but to ignite positive and meaningful change within our society.

About Clinical Benefit Advisory Team

The Clinical Benefit Advisory Team (CBAT), a subsidiary of Discovery Health, comprises Medical and Legal Advisors who offer clinical and legal expertise on complex cases. The Council Liaison Managers serve as the bridge between Discovery Health and the Council for Medical Schemes, providing support to the Legal Advisors. Additionally, the Medical Review Consultants ensure that clinical cases are thoroughly reviewed, and appropriate decisions are made. The team operates regionally in Sandton and Cape Town.

Key Purpose :

This position requires the successful candidate to manage legal disputes, as well as to provide legal assistance to Discovery Health when necessary .

Key Outputs

The successful applicant will be responsible for but not limited to the following job functions:

• Argue cases at Disputes on behalf of DHMS at weekly Dispute Hearings.

• Manage and own the entire Dispute Process and the relevant workflow pools.

• Assist senior legal advisor to respond to legal letters of demand from members.

• Provide legal assistance in respect of appeals to Council.

• Assist senior legal advisor in managing the mediation process before a matter goes on appeal.

• Provide legal training to the Benefit Compliance Review team when required.

• Update the Benefit Compliance Review team and relevant business areas on Council for Medical Schemes and dispute rulings as required.

• Monthly and quarterly trending and status reports.

• Assist in and provide advice on legal matters pertaining to Discovery Health e.g. Application of the Medical Schemes Act and Regulations to funding decisions.

• Draft heads of arguments for appeal and dispute matters.

• Investigate cases prior to going for disputes.

• Track industry trends relating to the Appeal committee and the Disputes Committee.

• Record keeping according to company requirements

Competencies:

The successful candidate must demonstrate the following competencies:

Role Specific Behaviours

☒ Ensures accountability.

☒ Action oriented

☒ Manages ambiguity.

☐ Attracts top talent.

☐ Business insight

☒ Collaborates

☒ Communicates effectively.

☒ Manages complexity.

☒ Manages conflict.

☒ Courage

☒ Customer focus

☒ Decision quality

☐ Develops talent

☐ Values differences

☐ Directs work.

☒ Drives engagement

☐ Financial acumen

☐ Global perspective

☒ Cultivates innovation.

☐ Interpersonal savvy

☒ Builds networks.

☒ Nimble learning

☒ Organizational savvy

☐ Persuades

☒ Plans and aligns.

☒ Being resilient

☒ Resourcefulness

☒ Drives results

☒ Demonstrates self-awareness.

☒ Self-development

☒ Situational adaptability

☒ Balances stakeholders

☒ Strategic mindset

☐ Builds effective teams.

☐ Tech savvy

☒ Instils trust.

☒ Drives vision and purpose

☒ Optimizes work processes

Education and Experience :

The following requirements are essential:

• Matric

• LLB qualification

• At least 1 year working experience in the medical schemes environment

• Knowledge of Managed Care Environment

• Excellent written and verbal communication skills in English

• Basic computer literacy in Microsoft Office applications (must be proficient in Excel)

• Drafting of legal documents eg. Heads of Argument, opinions and legal letters

The following requirements are advantageous:

• Knowledge of Discovery Health Medical Scheme and In-House products and protocols

• At least two years’ experience in large law firm

• Clinical /Medical knowledge

EMPLOYMENT EQUITY

The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.