Job Description
Position Purpose:
The Clinical Manager is responsible for making clinically sound funding decisions for complex cases in accordance with scheme rules and evidence‑based medicine principles. The role includes providing clinical guidance, supporting operational teams, engaging with external healthcare providers, and contributing to continuous improvement of clinical processes and outcomes.
Experience & Qualifications:
- Health‑related qualification and appropriate clinical training (Registered Nurse, Enrolled Nurse, Clinical Associate).
- Valid registration with the relevant professional body.
- More than four years’ experience in the managed healthcare industry.
- Solid knowledge of Prescribed Minimum Benefits.
Advantageous
- At least one year of experience in a Medical Advisory team.
- Proficiency in internet research, Outlook, and MS Office.
- Clinical coding knowledge (ICD‑10).