• This role involves directing and managing medical management within claims operations, including medical assessments, claim payments, rehabilitation, reintegration, and return-to-work processes.
• The incumbent will analyse medical management trends and develop, review, and implement policies, procedures, and processes.
• Additionally, the position provides oversight and guidance for all complex claims escalated to the Head of Clinical Services.
• The successful candidate will be expected to establish positive working relationships with healthcare providers, stay updated with medical technology, innovation, and the latest clinical information, and provide strategic input into annual planning and budget development to support strategic operational and individual performance objectives.

Minimum Requirements:

• Must be a qualified doctor with an MBChB degree, registered with the HPCSA.
• Over 10 years of clinical experience in a hospital or private practice setting, with healthcare management experience.
• More than 5 years of management experience, overseeing a team of 10 or more people.
• Previous experience in the medical aid industry is advantageous.
• Knowledge of the Compensation for Occupational Injuries and Diseases Act (COIDA) is also beneficial.
• Ability to collaborate effectively with the team and drive optimal performance.