Medical Practice Manager at Old Mutual Group

Job description

Reporting to the General Manager, Health Business the incumbent is responsible for the development and implementation of medical practice management practices at UAP Old Mutual aimed at providing leadership in the provision of healthcare to our members as well as managing costs and Healthcare outcomes.

The key objectives for this position are: -

• Develop and implement a Managed Care strategy aimed at coordinating medical care to achieve good patient experience better treatment outcomes and reduced healthcare costs.
• Manage contracts with service providers including developing innovative reimbursement options and positioning UAP as a partner to the providers.
• Overseeing case management practices at UAP.
• Provide leadership in developing metrics for measuring quality outcomes and obtain collaboration with service providers in meeting the set standards.
• Provide leadership in utilization of clinical and claims data to develop innovative products and processes that provide competitive advantage to UAP in health insurance services.
• Overall responsibility for managing chronic conditions and inpatient services cost outcomes.
• Guiding the business in compliance to health regulations relating to health insurance

Academic/Professional Qualifications and experience

• 1st Degree in medicine/pharmacy together with post graduate qualifications in healthcare management/health systems management/health economics/MBA
• At least 3 years’ experience in a health financing setting
• Demonstrated knowledge of managed care practices
• Business management training

Knowledge, Skills and Competencies

• Strong leadership and management skills
• Ability to work independently and build effective interpersonal relations
• Bias towards innovation and development of new ideas in problem solving
• Professionalism in dealing with both internal and external customers
• Effective communication both written and verbal

Key result areas and performance indicators

• Managed care strategy development
• Healthcare cost metrics
• Quality of care outcomes
• Patient experience metrics
• Health service providers engagement and coordination