67 Medical Management jobs in South Africa
US Tax Expert / Practice Management Expert
Posted 15 days ago
Job Viewed
Job Description
Job Description
About the company
- Tax Goddess (
- Our firm is recognized as a top 1% of Tax Strategist in the USA.
- With 19+ years of experience, we’re not your average number crunchers – we’re a progressive, 100% digital CPA firm. So, if you can handle cloud computing and rock basic tech skills, you’re in for a wild ride!
Job Overview
We are seeking a seasoned Practice Management Expert with a robust background in managing and optimizing the operations of USA CPA firms. The ideal candidate will bring extensive experience from a Big Four accounting firm (KPMG, PwC, EY, or Deloitte) and possess deep knowledge of the intricacies of US accounting practices. This role involves strategizing operational improvements, enhancing efficiency, and steering our practice toward achieving excellence in client service and compliance.
Responsibilities:
- Regulatory Compliance and Risk Management: Develop a comprehensive compliance framework that adheres to US and international accounting and tax regulations. Conduct risk assessments to identify potential compliance risks and implement mitigation strategies.
- Technology Integration and Digital Transformation: Spearhead the adoption of cutting-edge accounting technologies and digital tools to streamline workflows, improve data accuracy, and enhance client service delivery.
- Quality Assurance and Best Practices: Implement a quality assurance program that ensures all services meet the highest standards. Regularly review and update internal best practices, ensuring they reflect the latest in US accounting standards and practices.
- Client Service Innovation: Design and implement innovative client service models that leverage technology and personalized service strategies to enhance client satisfaction and loyalty.
- Strategic Financial Planning: Assist in the financial strategic planning of the firm, including budgeting, forecasting, and financial analysis.
- Market Expansion and Diversification: Analyze market trends and identify opportunities for expansion into new services, sectors, or geographies.
- Brand Development and Marketing Strategy: Collaborate with the marketing team to enhance the firm’s brand presence in the US market.
- Professional Development Programs: Establish a professional development program that supports continuous learning and skill advancement for staff.
- Sustainability and Corporate Social Responsibility (CSR): Integrate sustainability practices into the firm’s operations and client advisory services.
- Networking and Partnerships: Build and maintain strategic partnerships with other firms, technology providers, and professional organizations.
Qualifications:
- Education: Bachelor’s degree in Accounting, Finance, or a related field. A Master’s degree or CA/CPA certification is highly preferred.
- Experience: Minimum of 7 years of experience in practice management within a Top 10 tier accounting firm, with a specific focus on US CPA practices.
- Knowledge: Comprehensive understanding of US GAAP, IRS regulations, and US tax laws.
- Skills: Exceptional leadership, strategic planning, and communication skills. Proficiency in US CPA firm software and tools.
- Location: This is a remote position open to candidates based in India with experience in US practice management.
Working Hours:
- Our business hours for operations in the USA are from 8:00 am to 5:00 pm Mountain Standard Time (MST) in Arizona. Your specific or flexible duty hours will be discussed with your Head of Department (HOD).
Make your mark. Apply today!
Tax Goddess provides equal contractor opportunities to applicants and staff without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law.
#J-18808-LjbffrUS Tax Expert / Practice Management Expert
Posted today
Job Viewed
Job Description
Job Description
About the company
- Tax Goddess (
- Our firm is recognized as a top 1% of Tax Strategist in the USA.
- With 19+ years of experience, we’re not your average number crunchers – we’re a progressive, 100% digital CPA firm. So, if you can handle cloud computing and rock basic tech skills, you’re in for a wild ride!
Job Overview
We are seeking a seasoned Practice Management Expert with a robust background in managing and optimizing the operations of USA CPA firms. The ideal candidate will bring extensive experience from a Big Four accounting firm (KPMG, PwC, EY, or Deloitte) and possess deep knowledge of the intricacies of US accounting practices. This role involves strategizing operational improvements, enhancing efficiency, and steering our practice toward achieving excellence in client service and compliance.
Responsibilities:
- Regulatory Compliance and Risk Management: Develop a comprehensive compliance framework that adheres to US and international accounting and tax regulations. Conduct risk assessments to identify potential compliance risks and implement mitigation strategies.
- Technology Integration and Digital Transformation: Spearhead the adoption of cutting-edge accounting technologies and digital tools to streamline workflows, improve data accuracy, and enhance client service delivery.
- Quality Assurance and Best Practices: Implement a quality assurance program that ensures all services meet the highest standards. Regularly review and update internal best practices, ensuring they reflect the latest in US accounting standards and practices.
- Client Service Innovation: Design and implement innovative client service models that leverage technology and personalized service strategies to enhance client satisfaction and loyalty.
- Strategic Financial Planning: Assist in the financial strategic planning of the firm, including budgeting, forecasting, and financial analysis.
- Market Expansion and Diversification: Analyze market trends and identify opportunities for expansion into new services, sectors, or geographies.
- Brand Development and Marketing Strategy: Collaborate with the marketing team to enhance the firm’s brand presence in the US market.
- Professional Development Programs: Establish a professional development program that supports continuous learning and skill advancement for staff.
- Sustainability and Corporate Social Responsibility (CSR): Integrate sustainability practices into the firm’s operations and client advisory services.
- Networking and Partnerships: Build and maintain strategic partnerships with other firms, technology providers, and professional organizations.
Qualifications:
- Education: Bachelor’s degree in Accounting, Finance, or a related field. A Master’s degree or CA/CPA certification is highly preferred.
- Experience: Minimum of 7 years of experience in practice management within a Top 10 tier accounting firm, with a specific focus on US CPA practices.
- Knowledge: Comprehensive understanding of US GAAP, IRS regulations, and US tax laws.
- Skills: Exceptional leadership, strategic planning, and communication skills. Proficiency in US CPA firm software and tools.
- Location: This is a remote position open to candidates based in India with experience in US practice management.
Working Hours:
- Our business hours for operations in the USA are from 8:00 am to 5:00 pm Mountain Standard Time (MST) in Arizona. Your specific or flexible duty hours will be discussed with your Head of Department (HOD).
Make your mark. Apply today!
Tax Goddess provides equal contractor opportunities to applicants and staff without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law.
#J-18808-LjbffrMANAGER HOSPITAL RISK MANAGEMENT at MEDICAL SCHEME
Posted 7 days ago
Job Viewed
Job Description
Operational oversight of clinical risk, quality, and staff performance within the Hospital Risk Management department which includes pre-authorisation case management and clinical auditing.
Strategic leadership to drive continuous improvement, cost efficiency, innovation, and alignment to the Scheme's overall managed care strategy.
Key Performance Areas (KPAs)
Responsible for the design, development, implementation and monitoring of all hospital-based risk management to improve access to and ensure high-quality, cost-effective management of entire hospital incidents.
Promote a culture of accountability and professionalism, while developing systems, policies, and initiatives that proactively reduce clinical
KEY RESPONSIBILITIES
Clinical and Risk Management
- Lead continuous clinical, medical, and surgical risk evaluations, and report to the Scheme and company.
- Participate in the Clinical Review Team to support scheme and medical advisor decision-making.
- Stay current with clinical knowledge and new treatment modalities.
- Develop and implement clinical protocols, guidelines, and processes that drive quality and performance.
- Liaise with healthcare providers, scheme networks, and external stakeholders to manage member care pathways and mitigate clinical risks.
- Occasionally accompany case managers for onsite reviews of complex, high-risk cases.
- Analyse claims data and audit results to recommend targeted interventions that reduce fraud, waste, and abuse.
- Respond to Council for Medical Schemes (CMS) member complaints related to the department
Product & Scheme Development
- Assist with the conceptualisation, planning, and implementation of new managed care products.
- Contribute to medical scheme product development and benefit design.
- Stay abreast of industry developments, healthcare legislation, and regulatory requirements.
- Participate in tariff negotiations with hospital groups.
- Liaise with the Principal Officer and Medical Advisor for clinical alignment and strategic decision making
Operational Management
- Oversee day-to-day departmental operations and address operational inefficiencies.
- Ensure alignment of departmental performance with scheme sustainability goals and budget targets.
- Monitor and evaluate internal and external communication flows.
- Manage internal processes for confidential staff admissions, including pre-authorisation and appropriate claims payment.
- Coordinate weekly, monthly, and quarterly reports to business, schemes, and external hospital groups.
- Ensure adherence to SLAs and other compliance metrics.
Process Improvement & Systems
- Oversee the management and review of clinical SOPs, training manuals, and workflow documentation.
- Lead the implementation of new systems and process enhancements (e.g., IMed, Curus, Workflow, Billing Rules).
- Collaborate with Business Liaison and IT on system improvements; responsible for user testing and sign-off.
- Project manage new initiatives and enhancements from planning through to execution, including training and change management.
Leadership & People Management
- Provide coaching, mentoring, performance management, and quality control for team members.
- Drive a culture of accountability, professionalism, and service excellence.
- Manage staff KPAs, conduct quality control feedback sessions, and support disciplinary processes where necessary.
- Identify and develop talent through succession planning and continuous professional development.
QUALIFICATIONS AND EXPERIENCE
- Registered Nurse or Pharmacist
- A Minimum of 5-7 years experience in managed healthcare, hospital management clinical governance or medical scheme operations
- 3 years in a management or leadership role with experience managing clinical teams and driving strategic initiatives
- Legislation relating to the work of medical schemes
- A valid drivers licence is essential
Desired Skills:
- Registered Nurse or Pharmacist
- extensive experience within managed healthcare
- strong management skills
- extensive knowledge of hospital risk management within the medical schemes industry
CASE MANAGER HOSPITAL BENEFIT MANAGEMENT at MEDICAL AID ADMINISTRATOR
Posted 6 days ago
Job Viewed
Job Description
Purpose of the position
To actively manage the clinical appropriateness and risk (both financial and clinical) of all hospital events and associated healthcare services in accordance with the relevant scheme rules, clinical protocols and funding guidelines. To participate in the clinical review of exceptional cases and to engage with various stakeholders including treating providers, hospital case managers, medical advisors and colleagues.
Duties And Responsibilities
- Perform Clinical coding in accordance with CPT and ICD requirements and as per client standards
- Maintaining patient's clinical status in accordance with funder approval requirements for the duration of hospitalisation; keeping patients informed and managing the entire hospital stay's financial risk
- Provide complete and accurate updates and discharge information
- Receive hospital updates and assess each case based on clinical information - allocation of appropriate Length of Stay if clinically necessary
- Update Level of Care based on clinical information
- Review the costs to ensure cost effective and necessary care; balance cost and effectiveness of treatment to reduce re-admission
- Investigate and prepare cases for communication to the medical advisors, scheme, providers and members
- Member management of hospitalised patients with Chronic conditions who are registered on the active disease management programmes.
- Facilitation of the chronic and active disease registration of hospitalised beneficiaries who are diagnosed with one or more CDL conditions
- Escalation and resolution of unresolved high-cost cases
- Identification and preparation of high cost / high risk incidents and reported weekly to Clinical Specialist
- Discharge planning
- Communication with and support to Medical Advisors
- Call and written contact with Members and Providers
- Follow up on active cases with service providers relating to funding levels and updates (daily)
- Interpretation of medical reports
- Clinical decision making
- Registered Nurse
- Must be registered with SANC
- 3 to 5 years' experience within a managed healthcare or medical scheme environment
- Thorough, well-grounded clinical knowledge of hospital admissions, Length of Stay and Level of Care
- Excellent knowledge of the South African Healthcare industry and prevailing legislation, current coding structures e.
- ICD10's, CPT4, NRPL, PMB conditions and clinical protocols
- Extensive clinical knowledge related to all aspects of patient
- Solid understanding of value-based care
- Demonstrated ability to manage a portfolio of hospital cases
- Outcome focused with the ability to manage competing demands
- Establishing and maintaining effective relationships with key
- Ability to accurately update and maintain cases
- Excellent telephonic and written communication skills (will be tested)
- Computer literate - MIP/ Medcaps Application System (knowledge/ experience will be advantageous) and MS Office Suite of Products
- Reporting - MS Excel basic knowledge required (will be tested)
- Proficiency in English - verbal and written
- Verbal proficiency in additional languages will be an advantageous
- Flexibility to tracel and a valid drivers licence is essentail
- Hospital case management experience will be advantageous
- Nursing experience within an ICU would be preferable
- Registered Nurse
- Hospital Case Management experience
- ICD and CPT coding is essential
CASE MANAGER HOSPITAL BENEFIT MANAGEMENT at MEDICAL AID ADMINISTRATOR
Posted 10 days ago
Job Viewed
Job Description
Purpose of the position
To actively manage the clinical appropriateness and risk (both financial and clinical) of all hospital events and associated healthcare services in accordance with the relevant scheme rules, clinical protocols and funding guidelines. To participate in the clinical review of exceptional cases and to engage with various stakeholders including treating providers, hospital case managers, medical advisors and colleagues.
DUTIES AND RESPONSIBILITIES
- Perform Clinical coding in accordance with CPT and ICD requirements and as per client standards
- Maintaining patient's clinical status in accordance with funder approval requirements for the duration of hospitalisation; keeping patients informed and managing the entire hospital stay's financial risk
- Provide complete and accurate updates and discharge information
- Receive hospital updates and assess each case based on clinical information - allocation of appropriate Length of Stay if clinically necessary
- Update Level of Care based on clinical information
- Review the costs to ensure cost effective and necessary care; balance cost and effectiveness of treatment to reduce re-admission
- Investigate and prepare cases for communication to the medical advisors, scheme, providers and members
- Member management of hospitalised patients with Chronic conditions who are registered on the active disease management programmes.
- Facilitation of the chronic and active disease registration of hospitalised beneficiaries who are diagnosed with one or more CDL conditions
- Escalation and resolution of unresolved high-cost cases
- Identification and preparation of high cost / high risk incidents and reported weekly to Clinical Specialist
- Discharge planning
- Communication with and support to Medical Advisors
- Call and written contact with Members and Providers
- Follow up on active cases with service providers relating to funding levels and updates (daily)
- Interpretation of medical reports
- Clinical decision making
QUALIFICATIONS
- Registered Nurse
- Must be registered with SANC
- 3 to 5 years' experience within a managed healthcare or medical scheme environment
- Thorough, well-grounded clinical knowledge of hospital admissions, Length of Stay and Level of Care
- Excellent knowledge of the South African Healthcare industry and prevailing legislation, current coding structures e.
ICD10's, CPT4, NRPL, PMB conditions and clinical protocols
Extensive clinical knowledge related to all aspects of patient
- Solid understanding of value-based care
- Demonstrated ability to manage a portfolio of hospital cases
- Outcome focused with the ability to manage competing demands
- Establishing and maintaining effective relationships with key
- Ability to accurately update and maintain cases
- Excellent telephonic and written communication skills (will be tested)
- Computer literate - MIP/ Medcaps Application System (knowledge/ experience will be advantageous) and MS Office Suite of Products
- Reporting - MS Excel basic knowledge required (will be tested)
- Proficiency in English - verbal and written
- Verbal proficiency in additional languages will be an advantageous
- Flexibility to tracel and a valid drivers licence is essentail
- Hospital case management experience will be advantageous
- Nursing experience within an ICU would be preferable
Desired Skills:
- Registered Nurse
- Hospital Case Management experience
- ICD and CPT coding is essential
Mgr , Clinical Data Management
Posted today
Job Viewed
Job Description
Job Overview
Manage and support team of Data Management professionals to efficiently produce databases that meet customer requirements.
Essential Functions
• Manage a team of professional Data Management staff. Size of team could vary from 5+ upwards -15, depending on the Data Management Function. Define and prioritize resource requirements and manage resource assignments across projects. Directly responsible for utilization of staff. Assess and document competency of staff to satisfy position responsibilities. Regularly set goals and evaluates and documents performance. Propose salaries, promotion and termination actions. Actively contribute to recruitment of new staff. Implementation of department/office objectives. Provide expert review and guidance for production of Data Management deliverables including CRF/e-CRF, database design and set-up, validation definition and programming, Data Management Plan and database deliverables to internal and external customers. Provide technical advice and solutions with internal and external customers to solve problems and improve efficiency. Participate in the development and implementation of new processes and technology. Ensure that staff is trained and compliant with current operating procedures and work instructions and project scope of work. Identify and address professional development/training needs of staff. Mentor staff members to develop Data Management process, system, and drug development expertise. Provide operational input into proposals and scope of work. Participate in proposal defenses. Attend customer meetings and lead discussions of project requirements and strategic planning. Understand scope of work, budget, and scope assumptions. Identify out-of-scope work and provide revised costs with supporting documentation. Ensure project milestones are met according to agreed upon timelines. Actively manage quality throughout project. May be Project Manager/Project Lead for a major study or a series/group of studies. Manage staff in accordance with organization’s policies and applicable regulations. Responsibilities include planning, assigning, and directing work
• appraising performance and guiding professional development
• rewarding and disciplining employees
• addressing employee relations issues and resolving problems. Approve actions on human resources matters.
Qualifications
• Bachelor's Degree Clinical, biological or mathematical sciences or related field, or nursing qualification Req
• 7 years of relevant work experience including people management. Equivalent combination of education, training and experience.
• Advanced knowledge of Data Management processes and systems. Solid understanding of clinical drug development process. Excellent written and oral communication skills. Proven leadership skills. Excellent organizational skills and demonstrated ability to manage projects. Effective problem-solving skills. Ability to establish and maintain effective working relationships with coworkers, managers and clients. Advanced knowledge of Data Management processes and systems. Solid understanding of clinical drug development process. Excellent written and oral communication skills. Proven leadership skills. Excellent organizational skills and demonstrated ability to manage projects. Effective problem-solving skills. Ability to establish and maintain effective working relationships with coworkers, managers and clients.
#LI-HELENSCHOLTZ
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide . Learn more at
#J-18808-LjbffrMgr , Clinical Data Management
Posted 3 days ago
Job Viewed
Job Description
Manage and support team of Data Management professionals to efficiently produce databases that meet customer requirements.
**Essential Functions**
- Manage a team of professional Data Management staff. Size of team could vary from 5+ upwards -15, depending on the Data Management Function. Define and prioritize resource requirements and manage resource assignments across projects. Directly responsible for utilization of staff. Assess and document competency of staff to satisfy position responsibilities. Regularly set goals and evaluates and documents performance. Propose salaries, promotion and termination actions. Actively contribute to recruitment of new staff. Implementation of department/office objectives. Provide expert review and guidance for production of Data Management deliverables including CRF/e-CRF, database design and set-up, validation definition and programming, Data Management Plan and database deliverables to internal and external customers. Provide technical advice and solutions with internal and external customers to solve problems and improve efficiency. Participate in the development and implementation of new processes and technology. Ensure that staff is trained and compliant with current operating procedures and work instructions and project scope of work. Identify and address professional development/training needs of staff. Mentor staff members to develop Data Management process, system, and drug development expertise. Provide operational input into proposals and scope of work. Participate in proposal defenses. Attend customer meetings and lead discussions of project requirements and strategic planning. Understand scope of work, budget, and scope assumptions. Identify out-of-scope work and provide revised costs with supporting documentation. Ensure project milestones are met according to agreed upon timelines. Actively manage quality throughout project. May be Project Manager/Project Lead for a major study or a series/group of studies. Manage staff in accordance with organization's policies and applicable regulations. Responsibilities include planning, assigning, and directing work
- appraising performance and guiding professional development
- rewarding and disciplining employees
- addressing employee relations issues and resolving problems. Approve actions on human resources matters.
**Qualifications**
- Bachelor's Degree Clinical, biological or mathematical sciences or related field, or nursing qualification Req
- 7 years of relevant work experience including people management. Equivalent combination of education, training and experience.
- Advanced knowledge of Data Management processes and systems. Solid understanding of clinical drug development process. Excellent written and oral communication skills. Proven leadership skills. Excellent organizational skills and demonstrated ability to manage projects. Effective problem-solving skills. Ability to establish and maintain effective working relationships with coworkers, managers and clients. Advanced knowledge of Data Management processes and systems. Solid understanding of clinical drug development process. Excellent written and oral communication skills. Proven leadership skills. Excellent organizational skills and demonstrated ability to manage projects. Effective problem-solving skills. Ability to establish and maintain effective working relationships with coworkers, managers and clients.
#LI-HELENSCHOLTZ
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create connections that accelerate the development and commercialization of innovative medical treatments. Everything we do is part of a journey to improve patient outcomes and population health worldwide.
To get there, we seek out diverse talent with curious minds and a relentless commitment to innovation and impact. No matter your role, everyone at IQVIA contributes to our shared goal of helping customers improve the lives of patients everywhere. Thank you for your interest in growing your career with us.
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Benefit Management Clinical Analyst
Posted 7 days ago
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Job Description
Position: Benefit Management Clinical Analyst
Salary: Market related
Location: Centurion
Job type: Permanent
Industry: Pharmaceutical Benefit Management
Reference Number: CWR.MS.BMCA.23052025
COMPANY DESCRIPTION:
Our client is a South African pharmaceutical benefits management (PBM) organization and specialise in electronic claims processing and the management of medicine benefits. They are looking for a Benefit Management Clinical Analyst (Data Analyst) to join their Benefits Management department.
JOB DESCRIPTION:
To critically analyse and report on client specific data, consult with clients regarding medicine expenditure, benefit design and industry trends.
MAIN DUTIES & RESPONSIBILITIES:
Reporting
- Collect, clean, analyse and visualise data from various sources using advanced Excel and other BI models
- To develop reports and presentations for clients regarding their medicine utilisation and expenditure based on SLA or other client specific requirements
- To check and analyse reports created prior to distribution to clients
- To compile and communicate internal reports and analytics according to business decision requests/requirements
- To compile ad hoc reports for clients based on client request
Analysis and Consultation
- To consult internally with relevant departments regarding best practices and recommendations to clients (documentation and data analysis) to provide quality solutions to client specific needs
- To provide training regarding data analysis platforms (BI models) to internal and external clients
- To present findings and possible Benefit Design recommendations to clients, as and when required, which will address client marketing and financial positioning according to industry standards
- To help and guide colleagues relating to the clinical interpretations of reports and for presentation purposes
Research and Development
- To co-author (edit and audit, graphics) the annual publication (Company’s Medicine Review) to the industry to raise awareness of the Company brand
- Analyse data and provide support to the Pharmaceutics and Therapeutics committee (PTC) to enable funding decisions
- To attend and participate in various industry forums to stay abreast of clinical advancements and emerging trends, ensuring the implementation of best practices within the Company as well as to provide relevant information and insights during discussion
General Administration:
- To help according to operational and departmental needs
EDUCATIONAL REQUIREMENTS:
- Grade 12
- BPharm Degree (Master’s Degree will be advantageous)
- Registered with the SA Pharmacy Council
EXPERIENCE AND SKILLS REQUIRED:
- Proven working experience with data in various forms and on applicable platforms
- Minimum 3 years’ experience in the health care, medical aid industry or research
- Microsoft Office with Excel Advanced
- Valid driver’s license and own vehicle
- Knowledge and ability to work with BI models, e.g., Qlik Sense.
- Excellent verbal communication, presentation- and writing skills
- Ability to work with deadlines and managing client expectations
- Ability to deal with conflict and good time management
- Analytical and detail orientated
- Apply clinical and healthcare industry knowledge to analyses
- Capable of using initiative within scope of responsibilities
- Ability to work independently and in a multidisciplinary team
- Ability to establish and maintain effective working relationships with co-workers, managers, and clients
- Adaptable and flexible
- Critical thinking
TO APPLY FOR THE POSITION, PLEASE FOLLOW THE LINK BELOW:
POPIA
By Submitting your CV, you confirm that:
- We may retain your personal information in our database for future matching.
- We may contact you when suitable opportunities arise.
- The information you have provided to us is true, correct and up to date.
We endeavour to reply to each and every application, however, should you not hear back from us within 14 days please consider your application unsuccessful.
#J-18808-LjbffrBenefit Management Clinical Analyst
Posted today
Job Viewed
Job Description
Position: Benefit Management Clinical Analyst
Salary: Market related
Location: Centurion
Job type: Permanent
Industry: Pharmaceutical Benefit Management
Reference Number: CWR.MS.BMCA.23052025
COMPANY DESCRIPTION:
Our client is a South African pharmaceutical benefits management (PBM) organization and specialise in electronic claims processing and the management of medicine benefits. They are looking for a Benefit Management Clinical Analyst (Data Analyst) to join their Benefits Management department.
JOB DESCRIPTION:
To critically analyse and report on client specific data, consult with clients regarding medicine expenditure, benefit design and industry trends.
MAIN DUTIES & RESPONSIBILITIES:
Reporting
- Collect, clean, analyse and visualise data from various sources using advanced Excel and other BI models
- To develop reports and presentations for clients regarding their medicine utilisation and expenditure based on SLA or other client specific requirements
- To check and analyse reports created prior to distribution to clients
- To compile and communicate internal reports and analytics according to business decision requests/requirements
- To compile ad hoc reports for clients based on client request
Analysis and Consultation
- To consult internally with relevant departments regarding best practices and recommendations to clients (documentation and data analysis) to provide quality solutions to client specific needs
- To provide training regarding data analysis platforms (BI models) to internal and external clients
- To present findings and possible Benefit Design recommendations to clients, as and when required, which will address client marketing and financial positioning according to industry standards
- To help and guide colleagues relating to the clinical interpretations of reports and for presentation purposes
Research and Development
- To co-author (edit and audit, graphics) the annual publication (Company’s Medicine Review) to the industry to raise awareness of the Company brand
- Analyse data and provide support to the Pharmaceutics and Therapeutics committee (PTC) to enable funding decisions
- To attend and participate in various industry forums to stay abreast of clinical advancements and emerging trends, ensuring the implementation of best practices within the Company as well as to provide relevant information and insights during discussion
General Administration:
- To help according to operational and departmental needs
EDUCATIONAL REQUIREMENTS:
- Grade 12
- BPharm Degree (Master’s Degree will be advantageous)
- Registered with the SA Pharmacy Council
EXPERIENCE AND SKILLS REQUIRED:
- Proven working experience with data in various forms and on applicable platforms
- Minimum 3 years’ experience in the health care, medical aid industry or research
- Microsoft Office with Excel Advanced
- Valid driver’s license and own vehicle
- Knowledge and ability to work with BI models, e.g., Qlik Sense.
- Excellent verbal communication, presentation- and writing skills
- Ability to work with deadlines and managing client expectations
- Ability to deal with conflict and good time management
- Analytical and detail orientated
- Apply clinical and healthcare industry knowledge to analyses
- Capable of using initiative within scope of responsibilities
- Ability to work independently and in a multidisciplinary team
- Ability to establish and maintain effective working relationships with co-workers, managers, and clients
- Adaptable and flexible
- Critical thinking
TO APPLY FOR THE POSITION, PLEASE FOLLOW THE LINK BELOW:
POPIA
By Submitting your CV, you confirm that:
- We may retain your personal information in our database for future matching.
- We may contact you when suitable opportunities arise.
- The information you have provided to us is true, correct and up to date.
We endeavour to reply to each and every application, however, should you not hear back from us within 14 days please consider your application unsuccessful.
#J-18808-LjbffrClinical Data Management Lead, home-based in South Africa
Posted 4 days ago
Job Viewed
Job Description
RESPONSIBILITIES
- Serve as primary point of contact for customer on data management deliverables
- Manage multiple large studies or program of studies (possibly global)
- Provide leadership and senior support to DTLs on multiple large global programs of global studies
- Provide project management expertise working with customer data managers, key decision makers, and internal team members to manage continuous process improvements, issue escalation, workload projections, and provide technical expertise
- Lead direct negotiations with customer, e.g., timelines, financial, process, resources
- Meet with Data Operations team members on a regular basis to ensure milestones meet timelines and quality deliverables
- Independently manage DM service delivery with comprehensive DM process and technical expertise in executing projects
- Serve as the escalation point for unresolved data issues
- Ensure appropriate resources are assigned to meet project deliverables
- Create and/or review and sign-off on all data management plan (DMP) documents
- Manage service performance and provide leadership to identify root causes of issues and implement remedial actions
- Serve as Subject Matter Expert (SME)
- Provide leadership and expertise in a specific CDM task or technology
- Independently manage SOW/budget
- Independently bring process improvements and solutions to the CDM team/CDM department
- Lead a focus team or global or local best practice team
- Provide review and expert opinion in developing, revising, and maintaining core operating procedures and work instructions
REQUIRED KNOWLEDGE, SKILLS AND ABILITIES
- Previous experience and proven competence in managing delivery of multiple global trials through full DM life-cycle (i.e. large trials of at least 1000 patients)
- Demonstrated expert data management skills and advanced knowledge of the data management process (e.g., therapeutic area, extensive knowledge in DM processes, SAE reconciliation, external data vendor reconciliation)
- Previous experience and proven competence in handling complex customer negotiations and bid defense meetings independently
- Knowledge of Medical Terminology, Pharmacology, Anatomy, and/or Physiology
- Knowledge of operating procedures and work instructions and the ability to apply them in practice
- Knowledge of Good Clinical Practices and relevant regulatory guidelines
- Excellent communication, interpersonal, customer service, and teamwork skills
- Excellent organizational and problem-solving skills
- Excellent project management skills
- Ability to work independently
- Comprehensive understanding of clinical drug development process
- Ability to establish and maintain effective working relationships with co-workers, managers and customers
MINIMUM REQUIRED EDUCATION AND EXPERIENCE
- Bachelor’s Degree, or educational equivalent, in health, clinical, biological or mathematical sciences, or related field
- Around 7 years direct Data Management experience, including 5 or more years as a CDM project lead; or equivalent combination of education, training and experience
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at
#J-18808-Ljbffr