Healthcare Contracts and Compliance Specialist at GEMS

About the position

Introduction

Internal Advert - Healthcare Contracts and Compliance Specialist

The position of Healthcare Contracts and Compliance Specialist is vacant. The Healthcare Contracts and Compliance Specialist will report directly to the Healthcare Contracts and Compliance Manager and form part of the Healthcare Management Division. The position is based at GEMS Head Office in Pretoria.

The total remuneration package for this position is between R 1 193 734 per annum dependent of Skills and experience

The closing date for applications will be Monday, 23 February 2026.

Duties & Responsibilities

The Healthcare Contracts and Compliance Specialist will be required to provide support to the Contracts and Compliance Manager through the implementation of the following Key Performance Areas (KPAs):

• Develop operational reports and manage SLA compliance by contracted managed care service providers.
• Ensure the review of managed Care people, systems and processes is conducted during quarterly site visits.
• Evaluate contracts for timeous notice for renewal/termination and sign-off of contracts.
• Provide support in service provider interpretation sessions, winding down of terminated contracts and take-on sessions of new contracts within HM.
• Provide support in the end-to-end contracting management process for the Division.
• Support where required in respect of any provider network contracting in accordance with the approved phased programme.
• Handle the preparation and dissemination of contract-related correspondence.
• Support the development, implementation and monitoring of strategic and operational work plans of the Division.
• Track contractual reporting related to approved projects of the division.
• Support Project management of all contracts within the division to ensure that they comply with GEMS policies.
• Participate in relevant internal forums, committees and working groups to discuss compliance and risk management when required.
• Monitor divisional compliance with the legislative requests from various Stakeholders.
• Ensure scheduling and compilation of divisional Policies and SOPs are up to date and in compliance with Scheme processes.
• Ensure all contracted Service Providers adhere to BBBEE Sub-contracting requirements.
• Facilitate the divisional audit and risk register undertakings effectively and timeously.

Desired Experience & Qualification

Minimum requirements are:

• At least a 3-year Legal Degree or NQF Level 6 qualification in Compliance or risk management or similar
• Must have at least 5 years of experience in the development of contracts, management of compliance, risk and or audit, and presentation of management reports.
• Experience in the healthcare funding/medical scheme industry/contracting/compliance management environment or related field will be advantageous.
• Project Management experience will be an added advantage.
• Must be in possession of a valid driver's license and own vehicle.

Skills and Behavioural Competencies:

• Organised and have good time management skills.
• Excellent written and verbal communication skills.
• Analytical and problem-solving abilities.
• Ability to work independently and prioritize competing demands.
• Diligent work ethic with attention to detail.
• Self-motivated, proactive and collaborative team player.
• Resilient pressure management abilities.

Interested?

GEMS employs people with the highest level of integrity - submission to the appropriate pre-employment assessment is obligatory to be considered for the position.

Kindly note that the information provided on application of the position may be shared with a third party for vetting purposes and will be stored by GEMS for a period of 5 years.

Kindly note that information is required for Employment Equity Purposes and information gathered is strictly used according to the intended purpose of collection, unless there is a legal need or permission is granted from the applicant themselves to make use of it for other purposes.

Should you wish to have your information removed from the GEMS database, kindly send a request in writing to [Email Address Removed] .

GEMS adopts a hybrid work model.

GEMS is guided by the principles of employment equity. Preference will be given to groups who are underrepresented in accordance with GEMS employment equity plan.

Successful candidates will be required to seek approval to conduct other work outside of GEMS.

GEMS Employees are required to conduct themselves in a manner that reflects the organisation's paramount values: Excellence, Member Value, Integrity, Innovation, and Collaboration.