Senior Specialist: Managed Care

Executive Placements · Mamelodi

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Key Responsibilities

  • Analyse health data to stratify and segment member risk profiles.
  • Develop condition- and category-based care plans and intervention strategies.
  • Oversee healthcare risk management, including epidemic and chronic care response.
  • Implement and evaluate preventative care , curative care , and wellness programmes .
  • Manage hospital benefit interventions and ensure SLA targets are met.
  • Lead managed care implementation monitoring and stakeholder engagement.
  • Provide input on budgeting, forecasting, and cost control in managed care initiatives.

Minimum Requirements

  • NQF Level 7 Degree in Nursing or Health-related field.
  • Minimum 6 years' experience in managed care.
  • Demonstrated experience with:
  • Health data analysis
  • Care programme design
  • Stakeholder management
  • Budget and SLA performance monitoring

Key Skills & Competencies

  • Health Risk Assessment
  • Analytical thinking
  • Communication & Reporting
  • Project and Financial Management
  • Collaboration & Cultural Sensitivity
  • Governance and Compliance

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Senior Specialist: Managed Care at Executive Placements — Mamelodi · JobAlertsZA