The Manager: Medicine Management position is currently vacant. The Manager: Medicine Management role will report directly to the Senior Manager: Clinical Risk Management, and forms part of the Healthcare Management Division. The position is permanent and will be based at GEMS Head Office.

 The total remuneration package for this position is negotiable based on qualifications and experience.

The Manager: Medicine Management will be required to provide support to the Senior Manager: Clinical Risk Management through the implementation of the following Key Performance Areas (KPAs):

• Manage the correct and optimal utilisation of the GEMS medicine benefits.
• Medicine Management (acute and chronic) including formularies, other medicine lists and bi-annual Medicine Price List (MPL) review.
• Chronic Medicine registration and chronic member services.
• Pharmacy Benefit Management services contract oversight.
• Chronic Medicine Courier services contract oversight.
• Review, monitor, analyse and evaluate the services performed by members of GEMS Service Provider Network (SPN).
• Management of the utilisation, adjudication and payment of medicine benefits as per Scheme rules.
• Manage service provider interfaces that affect medicine management processes and claims processing.
• Support the Scheme’s strategic objectives and mandates. This includes the elements of innovation that are key to Schemes objectives.
• Systemic reviews of good practice guidelines currently available to ensure that Scheme funding decisions are evidence-based and in line with best practice. This activity aims to ensure that these elements are sound and in compliance with the Medical Schemes Act and Regulations, as well as the Scheme Rules at all times.
• Oversee the implementation of operational risk mitigation strategies with the SPN.
• Attend various Forums and make valuable contributions by providing the technical expertise required for strategic, medicine related and disease management services.
• Identification, scheduling and pro-active engagement with key pharmaceutical manufacturers and suppliers with the aim of creating access and value for GEMS members. 

Qualification, skills and competencies requirements are:

• Minimum 3-year Diploma/Degree in Medical/Clinical Sciences (B Pharm qualification advantageous).
• Minimum 5 years’ work experience in the healthcare funding/medical scheme industry including two years at management / supervisory level.
• Solid Medicine Benefits Operations experience and Medical Schemes operational insight.
• Be organised and have good time management skills.
• Be analytical and can manage priorities.
• Have excellent written and verbal communication and interpersonal skills.
• Can work well as part of a team.
• Be computer literate on advanced level.
• Have a diligent work ethic with attention to detail.
• Be self-motivated and pro-active (self-starter).
• Leadership, Coaching and Mentoring skills.
• Have resilient pressure management abilities.
• Must be in possession of a valid driver’s license and own vehicle and be willing to travel at short notice.
• Must have experience in the development and presentation of management reports.