Medical Advisor

Position: Medical Advisor )

Medical Advisor (Pretoria)

July 2, 2025//in /by Vacancy:
Medical Advisor
Location:
Head Office, Pretoria
Type:
Full-time | On-site Are you an experienced Medical Doctor looking to take your clinical expertise beyond practice and make an impact within the managed healthcare environment? Our client, a reputable player in the healthcare sector, is seeking a skilled Medical Advisor to join their team.
About the Role: This key position will see you supporting accredited managed healthcare services to ensure compliance with the Medical Schemes Act, industry guidelines, scheme rules, and evidence-based protocols. Youll play an integral role in guiding funding decisions for complex clinical cases, promoting cost-effective, quality care, and building strong relationships with healthcare providers and other stakeholders.
Key Responsibilities: Provide expert clinical support to executive and clinical teams across various areas including pre-authorisation, hospital case management, oncology, and disease risk management Conduct daily clinical reviews, prepare cases for presentation, and communicate funding decisions clearly to providers, members, and stakeholders Participate actively in internal and external clinical forums and committees Stay updated with clinical trends, legislative changes, and industry developments, providing guidance on their impact Assist in the development of protocols, funding guidelines, and treatment baskets Maintain effective workflows, meet turnaround times, and support continuous improvement initiatives Minimum Requirements: MBChB qualification with valid HPCSA registration Additional post-graduate certifications advantageous 35 years experience in a medical scheme or managed healthcare environment In-depth knowledge of the Medical Schemes Act, PMB legislation, Council for Medical Schemes publications, and healthcare industry coding (ICD
10, CPT, RPL, etc.) Clinical experience in a private hospital or clinic setting Technologically strong/ adept Use of Healthcare Apps/ Telehealth platforms/ Exposure to robotically aided surgeries etc Financially savvy pertaining to healthcare funding versus benefit principles, coupled with strong negotiation skills Solid understanding of health economics and health metrics reporting Excellent communication skills both verbal and written Proficiency in Microsoft Office;

experience with healthcare systems is an advantage Key Attributes: Accountable and results-driven Clear communicator with excellent relationship-building skills Collaborative and solutions-focused Customer-centric approach Adaptable, embraces technology and healthcare innovation Apply today with supporting documents (CV, qualifications, HPCSA registration)