Legal Advisor at Discovery Limited

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 broad 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 to the appeal board decisions, to assist with the implementation into Discovery Health.
• Record keeping according to company requirements.