GEMS Vacancies

To apply, click on the link at the end of the posts and all the best with your applications.

Senior Manager: Internal Audit Clinical and Data Analytics

Introduction

The position of Senior Manager: Internal Audit Clinical and Data Analytics is vacant. The Senior Manager: Internal Audit Clinical and Data Analytics role will report directly to the Chief Audit Executive and form part of the Internal Audit Division. The position is permanent and will be based at GEMS’s Head Office.

The total remuneration package for this position is between R1 613 106 and R 2 016 382 per annum, based on skills and experience negotiable based on qualifications and experience.

The closing date for applications will be Wednesday, 30 April 2025.

Duties & Responsibilities

The Senior Manager: Internal Audit Clinical and Data Analytics will be required to provide support to the Chief Audit Executive through the implementation of the following Key Performance Areas (KPAs):

• Contribute to the development and management of the Audit Universe with a focus on clinical and technical areas (managed care, disease management, claims administration, tariff codes) and regulatory requirements.
• Lead the clinical and data analytics audit team in executing audits and developing CAATS test cases to enhance efficiency and accuracy.
• Contribute to the development of risk-based internal audit plans focusing on clinical and technical areas (managed care, disease management, claims administration, tariff codes) and regulatory requirements.
• Manage stakeholder relationships both internally (GEMS management) and externally (service providers).
• Drive the development and implementation of a comprehensive Data Analytics Strategy for the Internal Audit department.
• Ensure integration of data analytics into the audit lifecycle, moving from traditional methods to proactive, risk-based approaches.
• Contribute to the aligned assurance efforts through coordination with other assurance providers.
• Manage audit resources, budgets, and timelines for allocated portfolios.
• Provide technical expertise and quality oversight on internal audit projects involving clinical data.
• Present findings and reports to the Audit Committee and other forums as and when required.
• Manage and develop staff through training, mentoring, and performance management.
• Contribute to risk management within allocated areas of responsibility while ensuring compliance with Internal Audit standards and methodologies.

Desired Experience & Qualification

Qualification Requirements:

• A Bachelor’s degree in Internal Auditing, BCom, BCompt, Degree in Medical / Clinical Sciences or other relevant degree.
• Certified Internal Auditor (CIA) or CA (SA) or a registered HealthCare Professional, or Masters.
• Minimum of 7 years of work experience in the medical scheme industry, particularly in Internal Auditing, with at least 4 years at a managerial level.
• Experience in delivery and management of outsourced service providers will be advantageous.
• Proven proficiency in understanding and application of standards for the professional practice of internal auditing.
• In-depth proficiency in MS Office and Data Analytics tools.
• Ability to lead audit teams and work independently, organise tasks efficiently and perform the audit function accurately.
• Strong verbal and written communication skills.
• Solid experience in managing and leading audit teams and, managing audit projects, managing personnel and overseeing the development of audit work programs.
• Knowledge of external leading risk and controls frameworks such COSO and ISO 31000.
• Strong understanding of clinical data management and audit processes.

Behavioural Competencies:

• Excellent analytical and problem-solving skills.
• Proficiency in data analysis tools and audit software.
• Strong written and verbal communication skills.
• Ability to work independently and lead a team.
• Attention to detail and strong organisational skills.

Prerequisite:

• Have an understanding of the medical schemes industry.
• Have an understanding of the use of data analytics tools to identify risks, anomalies, and trends across large datasets, enabling comprehensive risk assessments and predictive modelling.

Programme Manager

Introduction

The position of Programme Manager is vacant. The Programme Manager will report directly to the Senior Manager: Project Management Office and form part of the Office of the Chief Operations Officer. The position is based at the Head Office in Pretoria.

The remuneration package for this position is R1 386 956 per annum based on qualifications and experience.

The closing date for applications will be Thursday 24 April 2025.

Duties & Responsibilities

The Programme Manager will be required to provide support to the Senior Manager: Project Management Office through the implementation of the following Key Performance Areas (KPAs):

• Analyse information about the organisation’s strategic goals and objectives, internal and external influences, programme drivers and the benefits that stakeholders expect the programme to realise. Ensure Strategic Reporting of the Programmes in line with the Strategic Objectives and organisational priorities defined by the Strategy Office.
• Define and embed the Programme Roadmap, Benefits Management Plan and Risk management strategies and ensure they are aligned to the Strategic Portfolio of Programmes and Projects.
• Ensure the identification of programme benefits and the development of a benefits management plan based on the Business Case, Strategic Plan, and Strategic Objectives.
• Drive the End-to-end management of programmes, including effective programme formulation, Programme Planning, Programme Delivery, Monitoring and Reporting.
• Oversee and manage the development of critical programme governance documents, including business plans, programme charters and programme management plans and secure the acceptance and approval by the relevant programme stakeholders.
• Manage the performance of project managers and ensure projects are delivered in line with the project objectives.
• Provide Leadership support and coaching to Project Managers and ensure project risks and issues are addressed and escalated.
• Oversee the execution of projects assigned to project managers and ensure the delivery of all projects on schedule and within the approved scope in line with project objectives.
• Drive and manage the interaction and alignment with portfolio management to ensure programmes are provided with appropriate resources and prioritised.
• Drive engagements with governance bodies, programme sponsors, and strategy Teams to ensure the programme’s continued alignment with organisational strategy.
• Manage internal and external stakeholders to ensure that programmes receive appropriate strategic and operational support and that the benefits delivered by the programme can be effectively sustained.

Desired Experience & Qualification

Qualification requirements are:

• A 3year Degree / Diploma or NQF 6 equivalent in Project / Programme Management / Business Administration / Information Technology / Operations Management or related field. A post-graduate qualification and/or project management certification advantageous.
• Experience in implementing business and digital transformation programmes, and Software Development Lifecycle Projects is essential.
• Experience in implementing Healthcare Systems and Technologies will serve as an advantage.
• 5 to 8 years hands-on experience in Programme Management with at least 3 years of experience at a management/supervisory level.
• Hands-on experience and proficiency in the application of project management methodologies and Hybrid such as (PMBoK, Agile, Scrum, Waterfall, Prince, etc.)
• Project Management Professional (PMP) and/or Programme Management Professional Certification (PMP) Certification will be an added advantage.
• Agile Project Management Certifications essential (Agile PM DSDM, Disciplined Agile or Agile Scrum etc).

Other Skills:

• Proficiency in the application of project and programme management tools and artefacts (MS Projects, Projects Online and/ or any other project management tools).
• Strong Stakeholder Management and Problem-solving skills Adaptable and flexible in approach
• Change Management and Integration skills Strong communication skills and analytical expertise Leadership skills to guide project managers and program teams.
• A team player with a strong collaborative implementation approach Innovative, solution-driven and goal-orientated.
• Pay particular attention to detail, take initiative and easily identify and mitigate risk.
• Composure in a fast-moving, dynamic environment and very governance driven environment Knowledge of the South African medical scheme industry.
• Must be in possession of a valid driver’s license and own vehicle and be willing to travel at short notice.

Interested

The closing date for applications is Thursday, 24 April 2025. 

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.

Successful candidates will be required to seek approval to conduct other work outside of GEMS.

GEMS Employees are required to conduct themselves in a manner that reflects the organisation’s paramount values: Excellence, Member Value, Integrity, Innovation, and Collaboration.

CLO Unit Specialist

Introduction

The position of CLO Unit Specialist is vacant. The CLO Unit Specialist reports directly to the Senior Manager: Client Liaison Office and forms part of the Member Service and Experience Division. The position is based at the Head Office in Pretoria.

The remuneration package for this position is R 1 136 890 CTC per annum based on qualifications and experience.

The closing date for applications will be Thursday, 01 May 2025.

Duties & Responsibilities

The CLO Unit Specialist will be required to provide support to the Senior Manager: Client Liaison Office through the implementation of the following Key Performance Areas (KPAs):

• Oversee high-volume operational CLO teams to meet KPIs and SLAs.
• Optimize processes, improve efficiency, and simplify operational procedures.
• Analyse member experience, develop and implement strategies to improve satisfaction
• Assign action items and follow up with relevant parties and consolidate responses.
• Manage provincial escalations and resolve complex issues.
• Lead onboarding of new member groups.
• Collaborate with Provincial Management & Quality Assurance teams.
• Oversee provincial operations, ensuring alignment with goals and providing necessary support
• for efficient service delivery.
• Foster a culture of accountability, engagement, and improvement.
• Strategic contact for Provincial Managers.
• Conduct business reviews to assess satisfaction and growth opportunities.
• Collaborate across departments to ensure consistency and service excellence.
• Align operational strategies with scheme goals.
• Lead transformational initiatives to enhance efficiency.
• Identify operational risks and implement proactive solutions.
• Leverage technology to improve CLO operations and service interactions.

Desired Experience & Qualification

Qualification requirements are:

• Degree or Diploma in Operations management, Business administration or equivalent qualification.
• 5 years’ work experience in a similar role with 3 years of management experience.
• Experience in managing or overseeing teams.
• Strong knowledge of CRM systems.
• Proven track record of leading high-performing teams and managing large-scale projects.
• Demonstrated experience in process optimization and implementing technology-driven solutions to enhance.
• customer experience.
• Good planning and organising skills.

Business Process Manager

Introduction

The position of Business Process Manager is vacant. The Business Process Manager will report directly to the Senior Manager: Business Optimisation and form part of the Office of the Chief Operations. The position is based at the Head Office in Pretoria

The remuneration package for this position is  R 1 136 890  per annum negotiable based on qualifications and experience.

The closing date for applications will be Thursday 24 April 2025.

Duties & Responsibilities

The Business Process Manager will be required to provide support to the Senior Manager: Business Optimisation through the implementation of the following Key Performance Areas (KPAs):

• Manage and oversee the activities of Process Analysis, Design, Documentation, and Implementation to ensure process improvements and organizational efficiency.
• Develop and maintain the Scheme’s Business Process Architecture and repository.
• Manage and measure Business Process Maturity.
• Oversee Business Process Performance Measurements (Strategic and Operational).
• Ensure Business Process Standardization and best practices to maintain consistency and quality. Support continuous improvement initiatives across business processes.
• Manage Business Process Compliance & Governance to ensure processes meet regulatory standards. Develop Knowledge Management, training, and awareness initiatives related to BPM practices.
• Support risk management by identifying and mitigating potential risks within BPM.
• Collaborate with Audit and Compliance teams to ensure BPM processes align with internal and external audit requirements. Implement risk controls within BPM processes to ensure adherence to governance frameworks and regulatory standards

Desired Experience & Qualification

Qualification requirements are:

• Degree/Professional qualifications at NQF Level 6 in Business Management, Analysis, Information Technology, Engineering, Operation Management, or similar
• Certification in BPMN, AdBA, CBAP, or similar methodologies is advantageous.
• 5-8 years of experience in business process management, business analysis, business improvement, or related roles.

Other Skills :

• Enterprise systems development, Functional design, user requirement specifications, and Business case development
• Business Process Improvement framework/methodology, approach, process standards, tools, techniques, competencies, and practices aligning to IIBA best practices.
• Maintaining Business Process material, business process repository, and related documentation
• Expertise in business process modeling tools (e.g., BPMN, Visio, ARIS) Strong data analytics and reporting capabilities
• Experience with ERP systems and workflow automation tools Knowledge of compliance frameworks in a medical scheme environment

Click here to apply

We wish you all the best with your applications