Head of Department Health Policy Unit

Job Description,

A challenging opportunity exists for a strategic and experienced leader to head the Health Policy Unit. The ideal candidate will be responsible for ensuring the business proactiveness on new developments with articles written in medical journals for reviews. Responsible for ensuring the unit is adequately resourced in line with strategy of a Health Policy and Technology Unit. Ensuring the effective delivery of services, managing key relationships with internal and external stakeholders, and optimizing the overall management of HPU in line with both clients and the organization.

This position reports directly to the Executive: Managed Healthcare

, Requirements,

• Minimum MBChB
• Actuarial knowledge of Healthcare with the implementation of predictive model Qualifications in Health Technology Assessment or Evidence-Based Medicine and Health Economics
• At least 5 years work experience in the healthcare funding / medical scheme industry with at least 2 years at a Senior Management level
• Previous experience in a Health Policy Unit
• Experience in the evaluation of health technology assessments
• Must have experience in the development and presentation of management reports
• A good understanding of coding (Nappi, Tariffs, ICD10, CPT4, UPFS and more)
• A good understanding of the South African Healthcare Industry
• A good understanding of the Medical Schemes Act
• The ability to conduct research using a variety of academic and market-related resources
  
  

, Duties and Responsibilities,

• Ensuring the unit is set up and resourced in line with the requirements for HPU
• Development of policy and practice within all areas of Managed health care
• Research, investigate and publish relevant, timely and accessible articles and commentaries to support policy making, Health Technology HT), academia interested in health policy developments.
• HT, including drug discovery (section 21), diagnostics, medicines, devices, therapeutic delivery and eHealth Systems
• Cross national comparisons on health policy using evidence-based approaches
• National studies on health policies in determining the outcomes of technology driven initiatives
• Evaluation of digital divide in mobility, access and affordability of healthcare
• Use methods ands Tools for evaluating the effectiveness of clinical and non-clinical holistically
• Develop and implement Healthcare indicators and benchmarks (measure/metrics) for adoption and diffusion for Managed healthcare services.
• Development of of models and frameworks to support policy and decision making
• Stakeholder engagements to ensure buy in at all levels and taking regulations and Health Economics in to
• Manage the administrative function within the business unit
• Manage and coordinate the conducting of systemic reviews of good clinical practice guidelines and health technology assessments; to ensure that Scheme funding decisions are based on best practice. This activity aims to ensure these elements are sound and compliant with the Medical Schemes Act and Regulations and the Scheme Rules.
• Conduct research in areas accountable within HPU, be it targeted research into local and international clinical guidelines and funding policies as well as proactive research on new developments.
• Critical review and analysis of current cost drivers and trends and compare with those of local and international sources for best practice.
• Assist in critically analysing medical literature and use of evidence-based principles to review and generate enhancements in funding protocols.
• Assist in the management and monitoring of clinical cost targets
• Assist in developing and maintaining adequate knowledge of data handling and interpretation of information translating interventions.
• Support the Medical Advisory Services Unit in the Scheme’s exception management in researching evidence-based medicine
• Ensure active management and development of Scheme’s product development and benefit design activities
• Manage the review of the Scheme’s funding policies, protocols and formularies
• Develop and manage Scheme- Programmes in line with HQA measures
• Chair and coordinate monthly SPN meetings for HPU
• Ensure proactive management of Services in line with Agreement with delivery of monthly reporting to Scheme’s
• Management and monitoring health industry by implementing strategies that give results within set targets
• Management of the unit budget in line with budget allocation
• Monitor project/programme in line with Project Management principles in meeting the stakeholders requirements.
• Ensure that all relevant projects are carried out and finalised
• Represent the PPSHA in Stakeholder Engagements
• Represent PPSHA from a managed care perspective in forums
• Support the Scheme’s Clinical Advisory Expert Panels once formed
• Management and development and maintenance of Medical Advisory Services standard operating procedures and policies.
• Outcome based clinical reviews of Scheme’s Disease Risk Management Programmes
• Assess and mitigate risks within the Unit
• Manage relationship building with key stakeholders
• Manage, Monitor and evaluate clinical cost targets in line with HQA measures
• Manage and assist staff in developing Personal Development Plans, Training Plan and succession plan in accordance to HR policy Diary management