Position Purpose: 

• To be the product specialist in Medscheme products with the aim of ensuring that the products are effective and that the operational control environment is adequate. Support for the implementation of solutions for identifying, rectifying and preventing problems within the business unit.

Experience & Qualifications: 

• 6  8 years’ experience including Leadership, Quality Assurance and Risk, Operational Content and Process Management, Medical and Health industry, Healthcare Programmes and Scheme Rules.
• Continuous improvement:
• Implement practical solutions that use the specialist and departmental systems and processes  Provide specialist input and recommendations to improve the efficiency, compliance and quality objectives related to the area of specialisation  Identify problems and develop and propose solutions to present to appropriate leader or stakeholders  Ensure day to day operational support required from area of specialization is provided to enhance performance.
• Provide Specialist expertise and ensure best practice related to specialisation is implemented in projects, when required  Conform to project management disciplines when participating in projects  Represent department or project on appropriate committees related to area of specialisation 

Generic Objectives:

• Compliance Management 
• Conducts comprehensive post 
• Operational implementation reviews of Scheme Rule changes, policy changes and Managed Healthcare strategy changes. 
• Monitors compliance controls, tracks adherence to metrics, trend analysis and addresses deviations. 
• Ensures the implementation and achievement of the operational strategy to achieve operational efficiencies. 
• Liaise with stakeholders to promptly resolve issues, including Root Cause Analysis. 
• Develops and presents relevant and accurate support documentation. 
• Promotes a culture of compliance awareness and accountability within the organization. Offers subject matter expertise on projects. 
• Prioritizes and plans user issues related to their area of expertise in alignment with business priorities. Provides support for new services, including digital initiatives. 
• Reviews and contributes to Scheme reporting and audits. 
• Coordinates and ensures accurate bulk communication. 
• Maintains legal and regulatory compliance.
•  Generates regular reports on performance and compliance status. 
• Manage and Maintain Operational Content. 
• Quality and Risk Management
• Represent the business capability in the organization’s governance model.