Consultant Medical Management - 3 Year Contract
Six Sense Consulting
- R Undisclosed
- Contract Intermediate position
-
South Africa
- Posted 21 Jun 2025 by Six Sense Consulting
- Expires in 2 days
-
Job 2598444 - Ref JHB001241
About the position
A financial services business is seeking to appoint a Consultant Medical Management - 3 Year Contract. The Consultant: Medical Management is responsible to implement the medical management activities, medical exception handling and providing administration support in claims processing.
Qualifications:
- Bachelor’s Degree/Advanced Diploma in Health Sciences /Medical related qualification.
- Registration with HPCSA/SANCA
- Medical management
- Conduct medical assessment and compile injury assessment reports.
- Conduct assessments and bill reviews on submitted claims, focusing on the appropriate level of care, the length of stay, and quality of care.
- Incorporate tariffs, cost savings initiative recording, and treatment protocol to ensure that all service providers adhere to the rules, and the tariff as guided by the RAF and / or any that is considered reasonable.
- Pre-authorise submitted claims
- Escalation of complex cases for multi-disciplinary review and adjudication.
- Participate in the consultations process on the implementation of medical claims processes.
Experience:
- Relevant 3 years’ experience in a Medical related environment
- Claims management process/ processes and systems.
- Medical product management
- Medical bill reviewing
- Medical case management
- Complex problem identification, solving and decision making
- Customer value proposition
- Strong clinical analytical capabilities
- Knowledge of motor vehicle accident legislation
- Planning, Organising and Coordinating.
- Personal Mastery.
- Judgement and Decision Making.
- Ethics and Values.
- Client Service Orientation.
Please note that if you have not received a response within 14 days of submitting your application that your application was unsuccessful.
However, please keep a lookout on our website, [URL Removed] for available positions which may be inline with your career aspirations.
Desired Skills:
- Health Sciences
- Medical related qualification
- Medical management
Six Sense Consulting
About the agency
Six Sense Consulting is a Level 1 BBBEE, Recruitment & Consulting Company that was formed in 2012. We provide highly qualified and skilled resources that are placed in blue chip companies where specialised competencies and skills are required.
We are the preferred and trusted recruitment professionals with extensive industry expertise to assist both our clients and candidates.
As a highly skilled team, we are committed to the provision of excellent customer service, quality staffing and competitive pricing.
We strive to continuously build strategic partnerships with our clients to ensure we provide a value add to their business and help our clients grow their business to achieve their overall goals.
We pride ourselves in world class recruitment technology to source the most talented candidates that are a perfect match to the clients job requirements, their culture and team
Six Sense Consulting is an Engineering, IT and Management Consulting Recruitment Company that provides technical and project management resources, systems and solutions to the Engineering, IT and Telecommunications sectors.
The company was formed in 2012 and employs highly qualified and skilled resources that are placed in blue chip companies where competencies and specialized skills are required.
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