The 5 positions of Provider Liaison Officers are vacant. The Provider Liaison Officers will report directly to the Manager: Provider Liaison Office and forms part of the Healthcare Management Division. The positions are based in Western Cape Province.
The total remuneration package for these positions is negotiable based on qualifications and experience.
The Provider Liaison Officers will be required to provide support to the Manager: Provider Liaison Office through the implementation of the following Key Performance Areas (KPAs):
- Support the Manager: Provider Liaison Office in maintaining the GEMS relationship with healthcare providers within assigned region
- Participate in the review and submission of GEMS networks reports
- Support the Manager: Provider Liaison Office in the management of the Managed Care Organisations that are contracted by the Scheme
- Participate in the review of the providers efficiency reports
- Provide substantiated commentary on the quality of network services and provider compliance to the Scheme network agreements
- Represent the Healthcare Management Division at SPN and Stakeholder Engagements and promote network participation by healthcare providers
- Provide substantiated commentary on the quality of network services and provider compliance with Scheme network agreements
- Provide periodic reports relating all stakeholder engagements to the Manager: Provider Liaison Office
- Ensure continuous education on GEMS strategy, systems, processes and product to the providers within the assigned region
- Serve as a single point of contact for escalations related to claims and authorizations issues from the providers within the assigned region.
- Perform a secretariat function for the provider relations engagements
- Support other Scheme Division’s in managed care activities
- Fulfil various stakeholder engagements as directed by the Chief Healthcare Officer
Qualifications and other requirements are:
- At least a 3 year Diploma/Degree or equivalent NQF level in Clinical Sciences related fields
- At least 5 years work experience in the healthcare funding/medical scheme industry
- Must have experience in provider relations management
- Experience in case/ claims management will be advantageous
- Must have experience in the development and presentation of management reports
- Computer literacy and MS Office skills
- Sound Quantitative and qualitative analysis skills with ability to manage priorities
- Have ability to work well as part of a team
- Be responsible and reliable
- Have diligent work ethics with attention to detail
- Excellent communication and writing skills
- Have sound planning/project management skills
- Be a self-starter
- Own transport essential
Strong understanding of the Healthcare and Medical Scheme Industry (highly advantageous)
All external candidates, please apply via Career Junction using the following link :
https://www.careerjunction.co.za/companies/35144/government-employees-medical-scheme
Should you be interested, please apply for the position by emailing your CV to jobs@gems.gov.za The closing date for applications is 08 March 2023. Should you not hear from us by 31 May 2023, please consider your application unsuccessful.
*** GEMS employs people with the highest level of integrity – submission to the appropriate pre-employment assessment is obligatory to be considered for the position.
*** Kindly note that the information provided on application of the position may be shared with a third party for vetting purposes and will be stored by GEMS for a period of 5 years.
*** Kindly note that information is required for Employment Equity Purposes and information gathered is strictly used according to the intended purpose of collection, unless there is a legal need or permission is granted from the applicant themselves to make use of it for other purpose
*** Should you wish to have your information removed from the GEMS database, kindly send a request in writing to jobs@gems.gov.za.
*** GEMS adopts a hybrid work model
***GEMS is guided by the principles of employment equity. Preference will be given to groups who are underrepresented in accordance with GEMS employment equity plan.
The position of ICT Integration Specialist is vacant. The ICT Integration Specialist will report directly to the Senior Manager: Application Development and forms part of the ICT division. The position is based at GEMS Head Office, Pretoria.
The total remuneration package will be will be based on qualifications and experience.
The ICT Integration Specialist will be required to participate in the planning, coordination, and solution development and implementation activities related to the integration of applications and technologies within the organizations application integration environment. Proven communication skills, problem-solving skills, proficiency in programming languages and data structures, and knowledge of integration best practices are critical to successful performance in this role and providing support to the SM: Applications Development through the following KPA’s:
Key Performance Areas (KPAs):
- Develop and maintain services used in application integrations.
- Design integration solutions and document the design in accordance with best practices.
- Work with development teams to architect, design, build, and implement application integrations.
- Develop and maintain data integration components such as SQL queries, stored procedures, data extraction and cleansing, and integration with system front end components.
- Write PL-SQL code to retrieve appropriate data as derived from requirements.
- Build reports and/or data extracts to support business analysis.
- Support development on resolving system defects, acting as liaison in developing solutions.
- Coordinate directly with business analyst to best understand and analyze application integration business specifications.
- Provide technical assistance to troubleshoot and resolve integration errors.
- Assist application software developers and engineers in development of Application Program Interface (APIs) to interact with the application integration environment
- Design, develop, and deploy solutions within the organization’s architectural principles, policies, and guidelines
- Continually develop skills in the integration technologies in place in the AI environment, as well as staying informed on new developments in integration technology.
- Implement audit, logging, and monitoring solutions to provide proactive operational support in the AI environment.
Qualification requirements are:
- National diploma or university degree in the field of computer science, information technology, information systems or relevant degree
- Application Integration Certification is must.
- Experience in Application Integration role is a must.
- Full systems development life cycle experience.
- Minimum of 8 years relevant work experience in Application Architect.
- Certification in Application Integration is a must.
- Systems Development Lifecycle Management is essential. Project Management is an advantage.
- Knowledge of HealthCare Solution is an advantage.
- Competency with XML constructs and schemas.
- Technically fluent in programming languages, including .Net environment/ platform
- Experience with business and technical requirements analysis, business process modeling/mapping and methodology development, and data mapping
- Confidence and experience with API protocols and schemas such as SOAP and REST
All external candidates, please apply via Career Junction using the following link :
https://www.careerjunction.co.za/companies/35144/government-employees-medical-scheme
The closing date for applications is 2 September 2022. Should you not hear from us by 30 November 2022 please consider your application unsuccessful.
*** GEMS employs people with the highest level of integrity – submission to the appropriate pre-employment assessment is obligatory to be considered for the position.
*** Information is required for Employment Equity purposes.
*** Kindly note that the information provided on application of the position may be shared with a third party for vetting purposes and will be stored by GEMS for a period of 5 years.
*** Should you wish to have your information removed from the GEMS database, kindly send a request in writing to jobs@gems.gov.za.
***Gems is guided by the principles of employment equity. Preference will be given to groups who are underrepresented in accordance with Gems employment equity plan.
The position of ICT Integration Specialist is vacant. The ICT Integration Specialist will report directly to the Senior Manager: Application Development and forms part of the ICT division. The position is based at GEMS Head Office, Pretoria.
The total remuneration package will be will be based on qualifications and experience.
The ICT Integration Specialist will be required to participate in the planning, coordination, and solution development and implementation activities related to the integration of applications and technologies within the organizations application integration environment. Proven communication skills, problem-solving skills, proficiency in programming languages and data structures, and knowledge of integration best practices are critical to successful performance in this role and providing support to the SM: Applications Development through the following KPA’s:
Key Performance Areas (KPAs):
- Develop and maintain services used in application integrations.
- Design integration solutions and document the design in accordance with best practices.
- Work with development teams to architect, design, build, and implement application integrations.
- Develop and maintain data integration components such as SQL queries, stored procedures, data extraction and cleansing, and integration with system front end components.
- Write PL-SQL code to retrieve appropriate data as derived from requirements.
- Build reports and/or data extracts to support business analysis.
- Support development on resolving system defects, acting as liaison in developing solutions.
- Coordinate directly with business analyst to best understand and analyze application integration business specifications.
- Provide technical assistance to troubleshoot and resolve integration errors.
- Assist application software developers and engineers in development of Application Program Interface (APIs) to interact with the application integration environment
- Design, develop, and deploy solutions within the organization’s architectural principles, policies, and guidelines
- Continually develop skills in the integration technologies in place in the AI environment, as well as staying informed on new developments in integration technology.
- Implement audit, logging, and monitoring solutions to provide proactive operational support in the AI environment.
Qualification requirements are:
- National diploma or university degree in the field of computer science, information technology, information systems or relevant degree
- Application Integration Certification is must.
- Experience in Application Integration role is a must.
- Full systems development life cycle experience.
- Minimum of 8 years relevant work experience in Application Architect.
- Certification in Application Integration is a must.
- Systems Development Lifecycle Management is essential. Project Management is an advantage.
- Knowledge of HealthCare Solution is an advantage.
- Competency with XML constructs and schemas.
- Technically fluent in programming languages, including .Net environment/ platform
- Experience with business and technical requirements analysis, business process modeling/mapping and methodology development, and data mapping
- Confidence and experience with API protocols and schemas such as SOAP and REST
All external candidates, please apply via Career Junction using the following link :
https://www.careerjunction.co.za/companies/35144/government-employees-medical-scheme
The closing date for applications is 2 September 2022. Should you not hear from us by 30 November 2022 please consider your application unsuccessful.
*** GEMS employs people with the highest level of integrity – submission to the appropriate pre-employment assessment is obligatory to be considered for the position.
*** Information is required for Employment Equity purposes.
*** Kindly note that the information provided on application of the position may be shared with a third party for vetting purposes and will be stored by GEMS for a period of 5 years.
*** Should you wish to have your information removed from the GEMS database, kindly send a request in writing to jobs@gems.gov.za.
***Gems is guided by the principles of employment equity. Preference will be given to groups who are underrepresented in accordance with Gems employment equity plan.
