Medical Advisor

Direct message the job poster from AfroCentric Group To provide an objective and transparent scientific basis for the allocation of limited healthcare resources through the development and maintenance of clinical funding protocols and case manager guidelines. This is accompanied by provider and industry engagement, as well as guidance to client schemes and within business on the application of these protocols and guidelines.

Experience & Qualification

6 - 8 years clinical experience of which 2 years managed care experience advantageous, MBChB

Accountabilities

1. Provide clinical inputs on ex-gratia funding requests
2. Open, review and resolve all clinical queries and assessments through providing a clinical decision or requesting more information where required
3. Implement practical solutions that use the specialist and departmental systems and processes
4. Provide specialist input and recommendations to improve the efficiency, compliance and quality objectives related to the area of specialisation
5. Identify problems and develop and propose solutions to present to appropriate leader or stakeholders
6. Ensure day to day operational support required from area of specialisation is provided to enhance performance

Cost containment:

1. Support the identification, development and implementation of cost-effective processes to increase efficiency and reduce cost drivers related to area of specialisation
2. Continuously review cost / benefit and Return on Investment within area of specialisation
3. Engage with providers and pre-authorisation agents to build informed and supportive mutual relationships
4. Maintain a high level of impact on other departments to support improved delivery
5. Continually increase understanding of client and stakeholder needs, satisfaction and service delivery

Knowledge management:

1. Assess all high risk or high-cost medical procedures to ensure appropriate authorisation and claiming is facilitated
2. Provide clinical training / support to identified stakeholders
3. Provide medical advisory services to relevant parties
4. Ensure that adequate knowledge regarding specialisation is shared as required and maintained within the research library
5. Provide advice and / or training as required
6. Maintain, develop and implement specialist knowledge within the day to day operations of the organisation
7. Be a member of related professional bodies
8. Ensure CPD (continual professional development) or similar accreditation requirements are met annually to ensure maintained specialist accreditation

Network key relationships:

1. Engage with and provide support to the established network of internal and external expert resources and partners

Specialist support to projects:

1. Provide Specialist expertise and ensure best practice related to specialisation is implemented in projects, when required
2. Conform to project management disciplines when participating in projects
3. Represent department or project on appropriate committees related to area of specialisation

Position Specific Outputs

1. Provide expert orthopedic guidance and case assessments, particularly in consultations with treating providers. Strong knowledge of neurosurgical practices and conditions related to orthopedic care.
2. Evaluate patient cases to ensure alignment with funding and care policies.
3. Communicate complex medical information clearly and effectively to internal teams and external stakeholders.
4. Defend funding decisions in professional discussions, ensuring clarity and adherence to policies. Exceptional verbal communication skills with the ability to articulate and defend medical decisions.
5. Collaborate with clinical teams to enhance patient care strategies.

Knowledge:

1. Knowledge and application of relevant legislation
2. Knowledge of device industry
3. Ability to provide appropriate medical direction and advisory services
4. Knowledge and application of clinical principles and processes
5. Knowledge of clinical and funding protocol development
6. Clinical research and assessment
7. Knowledge of scheme rules and contractual negotiations

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. Should you not receive feedback within a month after applying, consider your application unsuccessful!

Seniority level

• Mid-Senior level

Employment type

• Full-time

Job function

• Health Care Provider
• Government Administration

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