Medical Advisor

AfroCentric Group; Wes-Kaap; On-site; ZAR 200 000 - 300 000; Full time

Job summary

A leading healthcare organization in South Africa is seeking a medical professional to ensure proper usage of scheme funds and provide clinical inputs. The role involves reviewing clinical assessments and implementing solutions to enhance service quality. Candidates must have a relevant medical degree and possess the ability to advise on medical matters. The ideal candidate will be skilled in clinical research, legislative knowledge, and protocol development, contributing to an inclusive work environment.

Responsibilities

• Ensure protection from over-utilisation or inappropriate claiming.
• Provide clinical inputs on ex-gratia funding requests.
• Review and resolve clinical queries and assessments.
• Implement solutions using departmental systems.
• Provide recommendations to improve efficiency and quality.
• Identify problems and propose solutions.
• Provide operational support to enhance performance.
• Assess high risk or high cost medical procedures.
• Provide clinical training/support.
• Offer medical advisory services.
• Develop and implement specialist knowledge.
• Ensure best practices related to specialisation.
• Participate in project management disciplines.
• Represent department in relevant committees.

Skills

Ability to provide appropriate medical direction and advisory services

Knowledge of scheme rules and contractual negotiations

Knowledge of relevant legislation

Clinical research and assessment

Knowledge and application of clinical principles and processes

Knowledge of device industry

Knowledge of clinical and funding protocol development

Education

Relevant medical degree

Job description

What Will You Do?

To ensure that the scheme or organisation is protected from over‑utilisation or inappropriate claiming by service providers that leads to abuse of member and scheme funds.

• Provide clinical inputs on ex‑gratia funding requests
• Open, review and resolve all clinical queries and assessments through providing a clinical decision or requesting more information where required
• Implement practical solutions that use the specialist and departmental systems and processes
• Provide specialist input and recommendations to improve the efficiency, compliance and quality objectives related to the area of specialisation
• Identify problems and develop and propose solutions to present to appropriate leader or stakeholders
• Ensure day to day operational support required from area of specialisation is provided to enhance performance
• Assess all high risk or high cost medical procedures to ensure appropriate authorisation and claiming is facilitated
• Provide clinical training / support to identified stakeholders
• Provide medical advisory services to relevant parties
• Maintain, develop and implement specialist knowledge within the day to day operations of the organisation
• Provide Specialist expertise and ensure best practice related to specialisation is implemented in projects, when required
• Conform to project management disciplines when participating in projects
• Represent department or project on appropriate committees related to area of specialisation

Qualification and Experience

• Relevant medical degree

Knowledge and Skills

• Ability to provide appropriate medical direction and advisory services
• Knowledge of scheme rules and contractual negotiations
• Knowledge of relevant legislation
• Clinical research and assessment
• Knowledge and application of clinical principles and processes
• Knowledge of device industry
• Knowledge of clinical and funding protocol development

Turnaround Time

The shortlisting process will only start once the application due date has been reached. The time taken to complete this process will depend on how far you progress and the availability of line managers.

Our Commitment to Transformation

AfroCentric is committed to transformation and embracing diversity. Our Employment Equity plan and targets will be considered as part of the recruitment process. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce, representative of the demographics of our society as well as people with disabilities.

Should you not hear from us within a month of applying, consider your application unsuccessful.