- Pretoria
- Salary: Market Related
- Job Type: Contract
- Sectors: Medical Health Fitness & Beauty Pharmaceutical
- Reference: Specialist Pharmaceutical Benefit Manager
Vacancy Details
Employer: To be disclosed
Our client, a managed care organisation based in Pretoria is looking for a Specialist Pharmaceutical Benefit Management to join their pharmacy team. This is an equal opportunity organisation with various businesses and/ or subsidiaries that service clients in the medical scheme and insurance industries.
Reporting to: Senior Specialist: Pharmaceutical Benefit Management
Location: On-site at the Head Office, Pretoria
Contract Type: Fixed-term Contract for period of 12 months (With the possibility of becoming permanent).
Salary: Subject to experience, market related Cost to Company (includes benefits such as medical aid, pension fund etc)
Candidate Requirements
- Registered Qualified Pharmacist Assistant (Post Basic)
- (Basic pharmacist assistant will not be considered for the position)
- Valid registration with SAPC (paid up to date)
- Minimum 3 years managed healthcare experience is essential.
- Excellent knowledge of all 27 CDL conditions, including HIV medicine and treatment regimes.
- Good knowledge of medicines to treat the 27 chronic disease list (CDL) conditions and clinical criteria requirements for
- each condition.
- Computer literate – MS Office product suite, Outlook, Word, Excel, and pharmacy dispensing software systems.
- Attention to detail is crucial.
- Demonstrate excellent customer-service and organisational skills.
- Strong telephonic and written communication skills (be able to manage difficult clients telephonically in a professional and
- calm manor).
- Proficiency in English (speak and write – will be tested).
- Additional languages (speak) will be an advantage – Sesotho, Setswana, isiXhosa, isiZulu.
- Competency in medical scheme medicine claim submissions, reversals, queries.
- Be able to understand claim rejections and how to resolve them.
- Handling complex queries effectively.
- Problem identification and resolution.
- Leadership skills, work independently and showing initiative.
- Analytical and critical-thinking skills.
- Strong reporting skills.
- Ability to work well with others.
- Ability to relate to people.
- Excellent communicator with ability to influence others.
- Basic business math skills and knowledge of mathematical/statistical concepts.
- Ability to maintain confidential and/ or sensitive information.
- Patient and a calm manner.
- High stress tolerance.
- Following through on commitments.
- Results orientation.
- Willing to enrol in courses to broaden their knowledge on medicine and related conditions to optimally manage our clients
Purpose of the position:
To perform drug utilisation review and actively manage and coordinate the approval of a member’s chronic medicine and to ensure that he/ she has access to this treatment within the available scheme benefit and medicine formulary. To participate in the clinical review of existing treatment and, where appropriate, assist with motivation for exceptional funding for non-formulary medicines and to engage with various stakeholders – both internal and external.
Qualifications:
Skills and Competencies Required:
8 people have applied for this job. 298 people have viewed this job.
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