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Medical Advisor

  • Writer: Medipath Team
    Medipath Team
  • Jul 11
  • 2 min read

As the leading medical recruitment agency in South Africa, our client has an exciting opportunity for a Medical Advisor to be based in Pretoria, South Africa.


The Client

Our client is a well-established healthcare risk management organisation based in Pretoria. They offer a range of managed care solutions and clinical support services to medical schemes and funders. With a strong commitment to quality, innovation, and cost-effective healthcare, the organisation supports ethical, evidence-based decision-making to improve member outcomes.


The Opportunity

This senior-level opportunity is ideal for a Medical Doctor with experience in managed healthcare or medical schemes. The Medical Advisor will be responsible for assessing complex clinical cases, guiding funding decisions in line with scheme protocols, and supporting internal clinical teams. The role requires excellent communication, sound clinical judgement, and a strong understanding of health economics and medical legislation.


Key Responsibilities

  • Provide clinical guidance on complex and high-cost cases

  • Review evidence to support funding decisions in line with scheme rules and protocols

  • Participate in case reviews, second opinions, and daily clinical discussions

  • Communicate funding decisions clearly and professionally to members, providers, and stakeholders

  • Support internal teams including pre-authorisation, case management, oncology, and chronic disease units

  • Attend and contribute to internal and external clinical forums and committees

  • Resolve coding and claims-related challenges in collaboration with the finance team

  • Monitor healthcare legislation and funding trends that impact managed care services

  • Contribute to treatment guideline and programme development

  • Provide cross-functional clinical support within the broader group


Requirements

  • MBChB degree with valid HPCSA registration

  • 3–5 years’ experience in a medical scheme or managed healthcare environment

  • Postgraduate certifications (advantageous)

  • Strong knowledge of the Medical Schemes Act, PMB legislation, and Council publications

  • Proficient in coding and billing systems (ICD-10, CPT, RPL, SAMA, etc.)

  • Clinical experience in private hospital or surgical settings

  • Familiarity with treatment basket development and value-based care strategies

  • Strong verbal and written communication skills

  • Proficiency in Microsoft Office and healthcare systems (advantageous)


Benefits

  • Senior clinical role in a structured and strategic environment

  • Opportunity to shape funding policy and clinical governance

  • Collaborative multidisciplinary setting

  • Market-related salary


Location: Pretoria, South Africa





If this vacancy is closed or you have any questions please contact apply@medipath.co.za Please be advised that you will be contacted by Medipath Healthcare Recruitment within 14 days should we wish to proceed with your application. Similarly, if you are not contacted by Medipath Healthcare Recruitment, please accept your application as unsuccessful. Your CV will automatically be added to our database and we could be contacting you should a suitable position arise.

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