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PRE-AUTHORISATION CONSULTANT: HBM X2
Introduction
Bestmed is a non-profit, mutual, self-administered medical scheme registered with the Council for Medical Schemes. We have been providing healthcare to the lives of South Africans for over 60 years. We are the largest self-administered scheme and the fourth largest open medical scheme in South Africa.
Bestmed strives to be an employer of choice by:
- creating a Personally Ours culture where we can all contribute in our unique way to make Bestmed the best employer for our Talent.
- creating an environment that optimises individuals to contribute their best version of themselves.
- promoting a highly engaged workforce in a performance enabling environment where employees are valued and rewarded for their commitment and dedication.
Bestmed has an excellent track record within the medical scheme industry:
- We ranked number one in customer experience in the 2022 Ask Afrika Orange Index®: Medical Aid Companies category.
- Our results for 2022 in the SA-csi’s medical scheme industry research places us at the forefront of customer experience in the South African medical scheme industry.
- We won the Financial Intermediaries Association of Southern Africa (FIA) Intermediary Experience Award 2022 for Product Supplier of the Year: Healthcare.
- We won the Titanium Award for Service to Membership in 2022, and for Creating Access to Quality Healthcare in 2022 and 2023
- We were honoured as the News24 Medical Scheme of the Year in the News24 Business Awards 2024
If you are willing to lead the way, go the extra mile, do the right thing, be upbeat and play for the team…you may be the perfect candidate to join a journey that is Personally Yours with Bestmed!
Duties & Responsibilities
Delivering cost-effective managed healthcare services to accomplish member satisfaction.
- Client Relations, To assist the client by approving appropriate funding. Maintain creation of new authorisations per day
- To deliver an effective call centre service in order to achieve member satisfaction. Maintaining the average calls taken per day.
- To deliver an effective call centre service in order to achieve member satisfaction.
- Risk Management ,To reduce the risk associated with hospital and authorized cases. Mistake profiles managed.
- Telephone Etiquette . Answering telephone calls in a way that achieves member satisfaction. Aim to be within the agreed standared procedure for working hours.
- Risk Management ,To reduce the risk associated with hospital and authorized cases
- Verifying prosthesis limit: To contain costs for both members and fund. Discount requested totals per year
- Attendance as per service contract.
- Awarding Beatzone badges
- On-going training and development, To update knowledge and skills in order to deliver a cost-effective and professional service.
- Effective Customar Service Delivary. To deliver an effective call centre service in order to achieve member satisfaction by keeping the average answering time within SLA
- Effective Customar Service Delivary. To deliver an effective call centre service in order to achieve member satisfaction by keeping the average abandoned call rate in SLA
- Effective Customer Service delivery.To deliver an effective call centre service in order to achieve member satisfaction and maintain departmental SLA.
- Delivering a cost-effective Managed Healthcare service. To deliver affordable Managed Healthcare services by maintaining the cost per admission.
- The actual benefit expenditure per beneficiary per month for hospitalization should be less than the budget benefit expenditure . Pre-authorization should be granted within the option benefits, Scheme and clinical protocols to maintain the average cost per beneficiary
Desired Experience & Qualification
Qualification
- Grade 12
- Enrolled Nursing
Experience
- Minimum 5 years’ experience as a nursing practitioner in ICU, Trauma, Theater or any other Specialised Ward
Additional inherent requirements
- Active SANC Membership
Click here to apply
ASSISTANT BOARD SECRETARY
Introduction
Bestmed is a non-profit, mutual, self-administered medical scheme registered with the Council for Medical Schemes. We have been providing healthcare to the lives of South Africans for over 60 years. We are the largest self-administered scheme and the fourth largest open medical scheme in South Africa.
Bestmed strives to be an employer of choice by:
- creating a Personally Ours culture where we can all contribute in our unique way to make Bestmed the best employer for our Talent.
- creating an environment that optimises individuals to contribute their best version of themselves.
- promoting a highly engaged workforce in a performance enabling environment where employees are valued and rewarded for their commitment and dedication.
Bestmed has an excellent track record within the medical scheme industry:
- We ranked number one in customer experience in the 2022 Ask Afrika Orange Index®: Medical Aid Companies category.
- Our results for 2022 in the SA-csi’s medical scheme industry research places us at the forefront of customer experience in the South African medical scheme industry.
- We won the Financial Intermediaries Association of Southern Africa (FIA) Intermediary Experience Award 2022 for Product Supplier of the Year: Healthcare.
- We won the Titanium Award for Service to Membership in 2022, and for Creating Access to Quality Healthcare in 2022 and 2023
- We were honoured as the News24 Medical Scheme of the Year in the News24 Business Awards 2024
If you are willing to lead the way, go the extra mile, do the right thing, be upbeat and play for the team…you may be the perfect candidate to join a journey that is Personally Yours with Bestmed!
Duties & Responsibilities
To ensure that the Bestmed Board and Executives fulfil their statutory requirements and to meet the demanding standards of corporate governance now required of companies. To attend to administrative duties as required by the Board and Executives.
- Board/Committee Meeting preparation
- Board/Committee Meeting Administration
- Maintaining a hard copy and an electronic storage system
- Board Governance
- Executive Management Committee meetings – editing of meeting pack
- EXCO/MANCO/TELCO meetings minutes
- Identified Board subcommittee meetings – editing of meeting pack
- Identified Board subcommittee meetings – minutes
- Combined Assurance Forum meetings – publishing of meeting pack and minutes
- Communication
- Other Board Secretariat functions
- Quality Improvement
Desired Experience & Qualification
Experience
- Minimum 2 years experience in editing / communication
Qualification
- Grade 12
- Diploma in Communication/Editing
Click here to apply
FINANCIAL ACCOUNTANT TEAM LEADER
About the role
We’re looking for a hands-on Accounting Team Leader who thrives on bringing order, insight, and momentum to finance operations. In this role you’ll play a key part in delivering accurate reporting that drives business decisions.
Duties & Responsibilities
- Cashflow management, query resolution , audit enquiries, approval of new vendor onboarding.
- Load or approve payments as and when required and other ad-hoc activities.
- Ensure month-end checks and posting of journals.
- Run analytics for variances and inconsistencies.
- Oversee and ensure integrity and accuracy in financial and administrative recording of assets.
- Oversee that the fixed assets as per the register are tagged.
- Ensure that the Fixed Asset Registers reconcile to the Trial Balance.
- Ensure correct values are given for disposal of assets and that such assets are identified and removed from register annually.
Desired Experience & Qualification
• Grade 12 with Accounting as a subject
• Accounting Degree
• Completed Articles
• Minimum of 2 years post-articles experience required
• 4 to 5 years relevant Finance experience
Click here to apply
MEMBERSHIP CORPORATE CONSULTANT
Introduction
Bestmed is a non-profit, mutual, self-administered medical scheme registered with the Council for Medical Schemes. We have been providing healthcare to the lives of South Africans for over 60 years. We are the largest self-administered scheme and the fourth largest open medical scheme in South Africa.
Bestmed strives to be an employer of choice by:
- creating a Personally Ours culture where we can all contribute in our unique way to make Bestmed the best employer for our Talent.
- creating an environment that optimises individuals to contribute their best version of themselves.
- promoting a highly engaged workforce in a performance enabling environment where employees are valued and rewarded for their commitment and dedication.
Bestmed has an excellent track record within the medical scheme industry:
- We ranked number one in customer experience in the 2022 Ask Afrika Orange Index®: Medical Aid Companies category.
- Our results for 2022 in the SA-csi’s medical scheme industry research places us at the forefront of customer experience in the South African medical scheme industry.
- We won the Financial Intermediaries Association of Southern Africa (FIA) Intermediary Experience Award 2022 for Product Supplier of the Year: Healthcare.
- We won the Titanium Award for Service to Membership in 2022, and for Creating Access to Quality Healthcare in 2022 and 2023
- We were honoured as the News24 Medical Scheme of the Year in the News24 Business Awards 2024
If you are willing to lead the way, go the extra mile, do the right thing, be upbeat and play for the team…you may be the perfect candidate to join a journey that is Personally Yours with Bestmed!
Duties & Responsibilities
The position demands meticulous attention to detail and a profound comprehension of how interactions with stakeholders can shape outcomes. Strong communication skills are essential, alongside the ability to swiftly devise alternative plans when necessary. You will be entrusted with full accountability for collecting contributions from dedicated profiles, necessitating a background in finance and proficiency in interpreting payment sheets and unique requirements. This role carries significant responsibility, requiring the capacity to perform under immense pressure, particularly during billing periods.
- Admin Turnaround
- Cyber & IT training
- ERROR %
- Managing Discrepancies
- Admin turnaround
- Cyber & IT training
- Error %
- Recon Management within 3 month mandate
Desired Experience & Qualification
Qualification
- Grade 12
- Diploma in Business Administration or similar
Experience
- Minimum 2 years membership administration and reconciliation experience
- Minimum 2 years Medical Scheme Industry experience
Click here to apply
DRIVER AND HANDYMAN
Introduction
Bestmed is a non-profit, mutual, self-administered medical scheme registered with the Council for Medical Schemes. We have been providing healthcare to the lives of South Africans for over 60 years. We are the largest self-administered scheme and the fourth largest open medical scheme in South Africa.
Bestmed strives to be an employer of choice by:
- creating a Personally Ours culture where we can all contribute in our unique way to make Bestmed the best employer for our Talent.
- creating an environment that optimises individuals to contribute their best version of themselves.
- promoting a highly engaged workforce in a performance enabling environment where employees are valued and rewarded for their commitment and dedication.
Bestmed has an excellent track record within the medical scheme industry:
- We ranked number one in customer experience in the 2022 Ask Afrika Orange Index®: Medical Aid Companies category.
- Our results for 2022 in the SA-csi’s medical scheme industry research places us at the forefront of customer experience in the South African medical scheme industry.
- We won the Financial Intermediaries Association of Southern Africa (FIA) Intermediary Experience Award 2022 for Product Supplier of the Year: Healthcare.
- We won the Titanium Award for Service to Membership in 2022, and for Creating Access to Quality Healthcare in 2022 and 2023
- We were honoured as the News24 Medical Scheme of the Year in the News24 Business Awards 2024
If you are willing to lead the way, go the extra mile, do the right thing, be upbeat and play for the team…you may be the perfect candidate to join a journey that is Personally Yours with Bestmed!
Duties & Responsibilities
The Driver and Handyman is responsible for providing safe and reliable transportation services as well as performing basic maintenance and repair tasks to support the smooth operation of the business. The role also includes conducting deliveries and collections for both internal and external stakeholders, ensuring that items, documents, materials, and equipment are transported efficiently, securely, and in a timely manner.
- Deliveries and Collections
- Repairs and Inspection
- Troubleshooting
- Equipment Selection
- Ad hock tasks
- Purchasing of Supplies
- Maintanance of company vehicle
- Administration
Desired Experience & Qualification
Experience
- Minimum 5 years handyman experience
- Minimum 5 years driving experience
Qualification
- Grade 12
Additional inherent requirements
- Code 10 Drivers license and PDP
Click here to apply
TEMPORARY ASSISTANT BOARD SECRETARY
Introduction
Bestmed is a non-profit, mutual, self-administered medical scheme registered with the Council for Medical Schemes. We have been providing healthcare to the lives of South Africans for over 60 years. We are the largest self-administered scheme and the fourth largest open medical scheme in South Africa.
Bestmed strives to be an employer of choice by:
- creating a Personally Ours culture where we can all contribute in our unique way to make Bestmed the best employer for our Talent.
- creating an environment that optimises individuals to contribute their best version of themselves.
- promoting a highly engaged workforce in a performance enabling environment where employees are valued and rewarded for their commitment and dedication.
Bestmed has an excellent track record within the medical scheme industry:
- We ranked number one in customer experience in the 2022 Ask Afrika Orange Index®: Medical Aid Companies category.
- Our results for 2022 in the SA-csi’s medical scheme industry research places us at the forefront of customer experience in the South African medical scheme industry.
- We won the Financial Intermediaries Association of Southern Africa (FIA) Intermediary Experience Award 2022 for Product Supplier of the Year: Healthcare.
- We won the Titanium Award for Service to Membership in 2022, and for Creating Access to Quality Healthcare in 2022 and 2023
- We were honoured as the News24 Medical Scheme of the Year in the News24 Business Awards 2024
If you are willing to lead the way, go the extra mile, do the right thing, be upbeat and play for the team…you may be the perfect candidate to join a journey that is Personally Yours with Bestmed!
Duties & Responsibilities
To ensure that the Bestmed Board and Executives fulfil their statutory requirements and to meet the demanding standards of corporate governance now required of companies. To attend to administrative duties as required by the Board and Executives.
- Board/Committee Meeting preparation
- Board/Committee Meeting Administration
- Maintaining a hard copy and an electronic storage system
- Board Governance
- Disputes Committee meetings – editing of meeting pack
- Disputes Committee meetings minutes
- Investment Committee meetings – editing of meeting pack
- Investment Committee meetings – minutes
- Social and Ethics Committee meetings – editing of meeting pack
- Social and Ethics Committee meetings – minutes
- Combined Assurance Forum meetings – publishing of meeting pack and minutes
- Communication
- Quality Improvement
- Board/Committee Meeting preparation
- Board/Committee Meeting Administration
- Maintaining a hard copy and an electronic storage system
- Board Governance
- Disputes Committee meetings – editing of meeting pack
- Disputes Committee meetings minutes
- Investment Committee meetings – editing of meeting pack
- Investment Committee meetings – minutes
- Social and Ethics Committee meetings – editing of meeting pack
- Social and Ethics Committee meetings – minutes
- Combined Assurance Forum meetings – publishing of meeting pack and minutes
- Communication
- Quality Improvement
Desired Experience & Qualification
Experience
- Minimum 2 years experience in editing / communication
Qualification
- Grade 12
- Diploma in Communication/Editing
Click here to apply
LEGAL AND CORPORATE GOVERNANCE MANAGER
Introduction
We are looking for a dynamic and strategic legal professional to join our team and play a pivotal role in shaping the governance, compliance, and risk landscape of one of South Africa’s leading medical aid schemes.
This is an exciting opportunity for a motivated individual who thrives in a fast-paced and purpose-driven environment. The successful candidate will provide expert legal advisory services, drive compliance excellence, manage governance and litigation matters, and contribute to strategic risk management initiatives across the Scheme. You will work closely with Executive leadership, while ensuring the organisation remains aligned with legislative and regulatory requirements.
If you are passionate about corporate governance, compliance, and making a meaningful impact within the healthcare industry, we invite you to be part of a team that values professionalism, innovation, and service excellence.
Duties & Responsibilities
Provide comprehensive legal support and advisory services to Bestmed. To manage the compliance program and reviews all legal and compliance issues/concerns within Bestmed. To assist the Executive with risk management and manage litigation and governance for and on behalf of the scheme. Assist with policy development in line with legislation.
- Contract and Supply Chain Management
- Risk management
- IR Management
- Implementation of compliance findings
- Provide legal and corporate governance advice to all stakeholders within the organisation
- Draft and vet all legal documents including letters, TOR’s, contracts, opinions, research papers, reports, etc.
- Manage and review litigation progress with management and external attorneys.
- Assist in providing the necessary governance support to staff and other relevant stakeholders.
Desired Experience & Qualification
Qualification
- Grade 12
- LLB
- Admission as an attorney
Experience
- Minimum 8 years of experience, of which 5 must be managerial experience
- Membership of the Legal Practice Council (Previously Law Society)
Click here to apply
EXECUTIVE: LEGAL, RISK AND GOVERNANCE
Job summary
To assist Top Management and Management in discharging their responsibility to comply with applicable regulatory requirements through the provision of compliance risk management services. To oversee the Corporate Compliance Program that reviews and evaluates all compliance issues/concerns within Bestmed. To take responsibility for identification, assessment, management, monitoring and reporting of any compliance risks faced by Bestmed by means of the Corporate Risk Register. To provide litigation services on behalf of the scheme. Assist with policy development in line with legislation.
Duties & Responsibilities
The role and responsibilities of the Executive: Legal, Risk and Governance include the following, but are not limited to:
Strategic and Governance Responsibilities
- Assist in the development and execution of the overall organisational strategy.
- Work closely with the Board of Trustees (BOT) and Executive Management to define and support Legal, Risk and Governance requirements.
- Compile, implement, and manage the Legal, Risk and Governance strategy and frameworks.
- Ensure compliance with King IV principles and other applicable governance standards.
- Ensure that BOT and Sub-Committee requirements are implemented across the Scheme.
- Monitor governance processes and resolve related issues where required.
- Prepare reports for the BOT and relevant Committees on legal, compliance, governance, and risk matters.
- Manage and maintain Bestmed Scheme rules – including securing approval from CMS.
Legal Advisory and Litigation Management
- Provide legal opinions and guidance to the BOT and Executive Management to support informed decision-making.
- Review, draft, negotiate, and manage contracts, service level agreements, and related legal documentation.
- Identify and advise management on legal risks and mitigation measures.
- Provide first-line legal support for disputes and litigation matters.
- Monitor and manage litigation processes in conjunction with management and external attorneys.
- Represent Bestmed at CMS appeal hearings and other relevant forums or proceedings.
- Interpret legislation, rulings, regulations, and industry developments, and assess their impact on the Scheme.
- Manage the Scheme’s Intellectual Property portfolio, including renewals, registrations, disputes, and liaison with appointed IP attorneys.
Compliance and Risk Management
- Oversee and maintain the Corporate Compliance Programme.
- Identify, assess, monitor, manage, and report on regulatory compliance risks.
- Maintain and update the Corporate Risk Register and provide regular reporting thereon.
- Verify that policies, procedures, and operational practices comply with legislative and regulatory requirements.
- Maintain and review the Compliance Charter and related compliance frameworks.
- Develop, maintain, and monitor compliance dashboards, standards of conduct, and ethical governance initiatives.
- Formulate compliance checklists for high-risk areas.
- Conduct or oversee compliance investigations and maintain records of complaints and investigation outcomes.
- Report material compliance breaches or regulatory violations to relevant internal and external stakeholders where required.
Fraud, Waste and Abuse Management
- Develop, implement, and oversee the Scheme’s Fraud, Waste and Abuse (FWA) governance framework and related control measures.
- Identify, assess, monitor, and report on fraud, waste and abuse risks across the Scheme.
- Ensure appropriate preventative, detective, and corrective controls are implemented to mitigate FWA risks.
- Oversee the investigation and management of suspected fraud, waste and abuse incidents in collaboration with internal stakeholders, forensic specialists, and external service providers where required.
- Monitor trends, emerging risks, and industry developments relating to fraud, waste and abuse within the healthcare funding environment.
- Provide guidance and recommendations to Management, Committees, and the Board of Trustees on FWA-related matters and mitigation strategies.
- Ensure appropriate reporting, record-keeping, and escalation of material FWA matters in line with regulatory and governance requirements.
- Promote awareness and a culture of ethical conduct through training, communication, and awareness initiatives related to fraud prevention and reporting obligations.
- Liaise with regulatory bodies, industry forums, law enforcement agencies, and other relevant stakeholders on FWA matters where required.
- Ensure that fraud prevention and ethical conduct principles are embedded within policies, procedures, and operational processes across the Scheme.
Policy, Training and Stakeholder Support
- Assist with the development, review, implementation, and communication of policies and procedures aligned to legislative requirements.
- Communicate and facilitate compliance-related guidance and training across the Scheme.
- Facilitate regular compliance meetings with compliance representatives across the organisation.
- Serve as a confidential point of contact for employees seeking guidance on compliance or ethical matters.
- Build and maintain strong stakeholder relationships while ensuring confidentiality and professional credibility.
- Ensure effective communication and collaboration between stakeholders.
Operational and Management Responsibilities
- Effectively report on agreed strategies, plans, objectives, and outcomes.
- Manage Legal, Risk and Governance operational planning, budgeting, resourcing, policy development, and training requirements.
- Manage day-to-day operations within the Legal, Risk and Governance function.
- Lead and manage employees within the function, including performance management, development planning, and capability building.
- Act as the escalation point for issues involving third-party service providers and assist in resolving conflicts where required.
Desired Experience & Qualification
- Grade 12.
- LLB Degree.
- Being an admitted attorney will be an added advantage.
- Membership of Compliance Institute of SA or similar body.
- A post graduate degree will be preferred.
- Minimum of 8 years of commercial experience, of which 5 must be managerial experience is essential.
- Medical Scheme Industry experience would be preferred.
Click here to apply
We wish you all the best with your applications
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