Senior Manager: Clinical Policy & Governance MMH260123-2

Role Purpose

Provide senior specialist leadership for the Clinical Policy and Governance function within Health Risk Management by ensuring robust, evidence-based clinical policy, regulatory interpretation, and coding standards. The role is responsible for guiding health technology assessment, PMB and statutory interpretation, and clinical coding frameworks to inform benefit design, risk management, and strategic decision-making.

Requirements

• Bachelor of Medicine or Bachelor of Surgery.
• Masters of Business Administration (MBA).
• Clinical Risk Management.
• Registation with the Health Professions Council of South Africa (HPCSA).
• Medical terminology, principles, processes and practices.
• South African legislation with regards to Medicine/Healthcare.
• Healthcare and clinical standards and best practices.
• Knowledge of the insurance industry.
• Relevant clinical and insurance legislation.
• ...

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