Clinical Executive Job Vacancy at Metropolitan Life in South Africa

Job Title: Clinical Executive x2 (Cape Town and Pretoria) (Reference # 9936) Metropolitan Health Job Band:8

Introduction

Reporting to the General Manager, two positions are currently available in Metropolitan Health Risk Management to support products in two Business Units at our Metropolitan Health division/business unit based respectively in Pretoria and in Cape Town office.

The Incumbent will be responsible for:


Coordinate actions between the client, Metropolitan Health Risk Management and the Administrator Metropolitan Health:
a. Understand the client’s view of Metropolitan Health Risk Management
b. Assist the client to implement their strategies through Metropolitan Health Risk Management.
c. Support Metropolitan Health Risk Management through client interaction.
d. Support MH in clinical aspects of interaction with the client, such as benefit design, rules, ex gratia cases, through interaction with Metropolitan Health Risk Management and MH staff.
Client retention:
a. Understand client stakeholders, scheme rules and exclusions.
b. Understand the client’s workplace programmes and health issues.
c. Understand other relationships that the client has with external stakeholders in the health industry.
d. Understand clinical risk and financial risk of the client and be able to interact with data structures in the business
Demonstrate value in Managed Care and give feedback to the business on managed care strategies in the client:
a. Understand the products of Metropolitan Health Risk Management and the workplace and wellness initiatives.
b. Represent the reporting function with the client.
c. Interact with Metropolitan Health Risk Management on processes to improve reports and to show value.
d. Interpret reports and take accountability for Exec summaries, in close interaction with the Metropolitan Health Risk Management product staff and reporting function.
Growth and profit and loss functionality.
a. Introduction of risk relevant products with the client
b. Client contract content and negotiations.
c. Joint product pricing responsibility with Metropolitan Health Risk Management.

You will have insight into and an understanding of the importance of industry issues.

As a senior manager and member of the management committee of the Metropolitan Health Risk Management you will engage at a strategic level in debates and activities that enhance the overall delivery of the Managed Care business within the MH/Metropolitan Health Risk Management stable for the schemes that you will have accountability for in terms of 1 to 4 above.

The applicant should meet these requirements:


A tertiary clinical qualification is a prerequisite and preferably a business degree or equivalent;
• Extensive medical aid/healthcare/ Managed Care knowledge and experience spanning at least 5 years;
• Extensive and sound management experience;
• A proven track record in terms of the key competencies listed above; and
• Ability to travel nationally on a regular basis

Competencies Required

Technical/Functional Competencies
• The ability to understand and act on issues facing and confronting medical schemes, in line with legislation and trends in the healthcare industry;
• The ability to analyse clinical and financial data in order to identify trends and risk management intervention opportunities;
• Delivering on customer requirements as per service level agreements (SLAs) and managing stakeholder relations;
• The ability to influence statutory compliance as governed by the Medical Schemes' Act and other legislations.
• Ensuring long-term sustainability and profitability of the business unit (business acumen).

Behavioural Competencies
• The ability to motivate people and deal with the conflict that goes along with interaction with client standards and stakeholders
• The ability to manage and influence relationships with all stakeholders, in particular the clients

Additional Information

Shortlisted candidate will be subjected to the following statutory checks:
• Reference
• ITC
• Qualification
• Criminal Check (job grade 6 and above)

“First preference will be given to candidates registered with the Redeployment Centre for this vacancy”. Kindly forward your updated CV to redeployment@mhg.co.za and indicate the reference number and name of the position on the email subject line.


How to apply

Internal applicants:

Sign on to PeopleSoft > Recruiting Activities > Careers

External applicants:

Go to our website

www.mhg.co.za

> Careers at Metropolitan Health> Vacancies

Assistance with online applications:

PeopleSoft Helpdesk (021) 940 5169

Contact Person:

Noyise Notiki

Telephone:

0214802769

Closing Date:

17 September 2012

Please state clearly for which position you are applying as well as the reference number in all communications. The job grade and remuneration will be commensurate with the successful applicant's experience, qualification and skills.