Medical Advisory Orthotist & Prosthetist

About the position

Medical Advisory Orthotist & Prosthetist
Location: Cape Town
Type: Hybrid/ Permanent
Ref: MVG/ORPR

Large Managed Care administrator seeks to employ a suitably qualified Orthotist/ Prosthetist with at least 4 years Managed Care experience for their Medical Advisory division. The core purpose of the role is to protect the scheme from over-utilization and inappropriate claims by service providers, safeguarding member and scheme funds.

Key requirements and responsibilities:

• Provide clinical input on funding requests
• Resolve clinical queries and assessments
• Implement solutions using departmental systems
• Offer recommendations to enhance efficiency and quality
• Identify issues and propose solutions
• Provide operational support for specialization
• Assess high-risk or high-cost procedures for appropriate authorization
• Provide clinical training and support
• Offer medical advisory services to internal and external stakeholders
• Ensure annual CPD is kept up to date
• Provide input support for specialist projects
• Engage with network providers
• Qualified Orthotist/ Prosthetist registered with HPCSA
• (Bachelor of Health Sciences in Medical Orthotics and Prosthesis)
• At least 4 years Managed Care experience or Private experience with working knowledge of ICD 10 Coding/ NAPPI Codes (Essential)

Apply now by sending your CV and supporting documents to [Email Address Removed].

Supporting documents:

• Copy of Comprehensive CV detailing relevant experience
• Copy of HPCSA Certification
• Copy of Degree
• Copy of Post Basic qualifications (if any)

Desired Skills:

• At least 4 years Managed Care experience or Private experience with working knowledge of ICD 10 Coding/ NAPPI Codes (Essential)

Desired Work Experience:

• 2 to 5 years

Desired Qualification Level:

• Degree