Senior Manager: Managed Care Corporate Schemes at AfroCentric Group

Job description

Position Purpose:

To lead the managed care operational teams and to provide support to departments, manage resources, processes and budget in order to deliver a customer-centric business environment. To ensure that the operational area is aligned to Medscheme and client schemes strategic objectives.

Experience

10 years managed health care experience including 5 years at a management level

Qualifications

Business Management and/or clinical degree.

Job Outputs:

Responsible for the following services for designated clients:

• Chronic Medicine Management, Prescribed Medicine Benefits, Hospital Pre-authorisation, Hospital Case Management, Back Office. In addition new services that may be rolled out from time to time e.g. Low Benefit Options, Wellness Initiatives, etc. This includes new business take-ons and wind downs
• Manage the revamping of clinical protocols and systems
• Plan and implement changes to the operations of the area of responsibility to respond to macro and micro-economic conditions, legislation, competition, market sentiment and the industry in general
• Communicate business plan in alignment with strategic context and strategic implementation plans to ensure operational best practice and continuous improvement
• Ensure reporting is in place to meet client expectations in terms of Service Level Agreements and other requirements
• Ensure appropriate, active and informative relationships with customers, value chain partners and industry players (if applicable) are in place