Senior Manager: Health Risk Management

Role Purpose

• Healthcare professional with deep expertise in health risk management, leading teams to deliver integrated managed care solutions. Demonstrated success in collaborating with the provider networks, clinical protocols, and health risk management strategies to achieve measurable improvements in quality of care and cost outcomes.
• The manager will lead the HRM team to fostering collaborative relationships, implementing utilisation management controls, and driving adherence to evidence-based practice aligned to the Momentum Health Integrated Value Proposition and design intent.
• He/she must work with cross-functional teams to develop and implement appropriate health risk management solutions and to ensure compliance with regulatory requirements and industry standards related to the delivery of managed health care.

Requirements

• Matric.
• A tertiary clinical qualification is a prerequisite i.e. the incumbent must hold a Bachelor's degree in healthcare administration, public health, or related field. e.g. MBChB, BPharm, BCur.
• 8 -10 years of experience in healthcare, with at least 5 years in health risk management.
• Knowledge of regulatory requirements e.g, limitations imposed on schemes and administrators.
• Must have a sound working knowledge of medical scheme legislation and managed care compliance requirements and a proven track record in terms of the key competencies listed above, including strong leadership and problem-solving skills.

Duties & Responsibilities

• Assist in the development of a model to support the HRM clinical outcomes.
• Develop, review, and execute service level agreement, in alignment with established guidelines and strategies.
• Collaborate within the broader solutions and provider networks team to contribute insights and recommendations for continuous improvement of our pricing structure, in relation to the health risk management function.
• Foster collaborative relationships with the Health operational and execution teams to enhance synergy and maximise collective success.
• Maintain detailed records of all clinical solutions, ensuring accuracy and accessibility for future reference.
• Improving efficiency in the team by continual improvement of models and reports.
• Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service.
• Collaborate and build relationships with product development and segment teams across Momentum Health Solutions.
• Make recommendations to improve client service and fair treatment of clients within area of responsibility.
• Positively influence and participate in change initiatives.
• Continuously develop own expertise in terms of professional, industry and regulatory knowledge.
• Contribute to continuous innovation through the development, sharing and implementation of new ideas.
• Take ownership for driving career development.
• Effectively manage time and ensure optimal productivity.

Competencies

• Business Acumen.
• Client/ Stakeholder Commitment.
• Drive for Results.
• Leads Change and Innovation.
• Collaboration.
• Impact and Influence.

Closing Date

• 2026/08/20