Function Other Facility Position Clinical Review Specialist x9 Introduction

Vacancies exist for Nine Clinical Review Specialist based in Cape Town Regional Office, reporting to the National Clinical Review Manager. The successful candidate will manage the financial, reputational and clinical risk of the business units by reviewing claims, conducting audits of patient records and claims regarding captured data on the LHC systems, billed items and contractual agreements. This person shall identify and highlight areas of non – compliances, manage, monitor, implement corrective actions and assess the effectiveness of corrective measures and report there on, to achieve the Life Healthcare objectives and strategy.

Critical Outputs

Management of financial risk by

The interpretation and application of different reimbursement contracts within the business units

RSRT and DRG profit/loss analysis and reporting

Engagement with funders ...