Job Description: There is currently a Specialist: Medicine Benefits Management vacancy. The Specialist: Medicine Benefits Management role will report directly to the Senior Manager: Clinical Risk Management, and forms part of the Healthcare Management division. The position is permanent and will be based at GEMS Head Office. Job Responsibilities: the Courier Pharmacies and the Pharmacy Benefit Management Services Provider; Oversee the implementation of operational risk mitigation strategies related to the adjudication and payment of pharmaceutical benefits. Management of the interface and inter SPN processes between: Management of the utilisation, adjudication and payment of Medicine benefits as per Scheme rules. Management of the technical aspects of the Courier Pharmacy Service Providers and Chronic Medicine benefits provided through the Courier Pharmacies. Draft member communication to support the correct and optimal utilisation of the medicine benefits. Attend various Forums and make valuable contributions by providing expertise needed to ensure sound management of medicine management services. Implementation of the regulatory compliance measures in relation to the adjudication and payment of Pharmaceutical Benefits. the Pharmacy Benefit Management Services Provider and the Administrator; and o the Pharmacy network manager and the Courier Pharmacies. Job Requirements: Ability to work well as part of a team. Analytical with excellent written and verbal communication. Minimum 3-year Diploma/Degree in Medical/Clinical Sciences (B Pharm qualification advantageous). Must be in possession of a valid driver's license and own vehicle and be willing to travel at short notice. Minimum 5 years' work experience in the healthcare funding/medical scheme industry including two years at management / supervisory level. Solid Medicine Benefits Operations experience and Medical Schemes operational insight Job Details: Company: Government Employees Medical Scheme - GEMS Vacancy Type: Full Time Job Location: Pretoria, Gauteng, SA Application Deadline: N/A Apply Here jobstrivia.net
Jobs Trivia | Pick a Job for Your Career