Assitant Director: Medical Payments

The Department of Employment and Labour · Pretoria, Gauteng

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REQUIREMENTS

Undergraduate qualification NQF Level 6 as recognized by SAQA in Accounting / Finance / Internal Audit / Informatics / Business Management or Administration / Operations Management / Public Administration / Health related qualification Nursing/Occupational Therapy/Physiotherapy. Four 4 years' functional experience in financial services/medical aid/claims processing environment of which 2 years should be at a Senior Practitioner/Senior Administrative.
Knowledge: Compensation Fund business strategies and goals. Public Service regulations, policies and procedures. Compensation Fund value chain and business process. COIDA, procedures and processes. Customer service Batho Pele Principles. Operations systems. Risk awareness. Technical knowledge. General knowledge of the Public Service Regulation. Medical related Legislation & Regulatory Knowledge & Implementation.
Legislative Requirements: COIDA.PFMA and National Treasury Regulations.
Skills: Communication verbal and written. Business Report Writing. Decision making. Conflict Management. Financial Management. Management Skills e.g. Team leadership, Planning and Organising, Problem solving and analysist etc. Analysing and Interpreting information. Medical bill reviewing. Medical Policy Management.
Medical aid knowledge case management. Project Management and Planning. Information Analysis and Interpretation. Clinical risk mitigation Clinical coding. Quality Assurance and Improvement. Stakeholder Development and Management.

Coordinate the finalization of medical invoices for Head Office and Provinces. Provide input in the development of policies and operational plans for Provinces.
Monitor medical payments to prevent wasteful expenditure for Head office and Provinces. Provide technical support to provincial offices and medical service providers. Management of all resources in the sub-directorate.