Medical Advisory – Orthotics / Prosthethics

Medical Advisory Orthotics / Prosthethics

May 27, 2024 / / in / by Position : Medical Advisory : Orthotist / Prosthetist Location : Cape Town Type : Hybrid / Permanent Ref : MVG / ORPR Large Managed Care administrator seeks to employ a suitably qualified Orthotist / Prosthetist with at least 4 years Managed Care experience for their Medical Advisory division. The core purpose of the role is to protect the scheme from over-utilization and inappropriate claims by service providers, safeguarding member and scheme funds. Key requirements and responsibilities :

• Provide clinical input on funding requests
• Resolve clinical queries and assessments
• Implement solutions using departmental systems
• Offer recommendations to enhance efficiency and quality
• Identify issues and propose solutions
• Provide operational support for specialization
• Assess high-risk or high-cost procedures for appropriate authorization
• Provide clinical training and support
• Offer medical advisory services to internal and external stakeholders
• Ensure annual CPD is kept up to date
• Provide input support for specialist projects
• Engage with network providers
• Qualified Orthotist / Prosthetist registered with HPCSA
• Bachelor of Health Sciences in Medical Orthotics and Prosthesis)
• At least 4 years Managed Care experience or Private experience with working knowledge of ICD 10 Coding / NAPPI Codes (Essential)

Apply now by sending your CV and supporting documents to . Supporting documents :

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