COUNCIL FOR MEDICAL SCHEMES (CMS) VACANCIES BULLETIN The Council for Medical Schemes is a statutory body established by the Medical Schemes Act (131 of 1998) to provide regulatory supervision of private health financing through medical schemes. The following position exists for the person driven by a desire to protect the public interest. SENIOR INVESTIGATOR The purpose of the job is to enforce compliance by ensuring that all regulated entities comply with the Medical Schemes Act & Regulations and the National Policy. As a Senior Investigator you will be responsible for: • Inspection and Investigations: - Institute and conduct investigations and report on the level of compliance with the MSA; - Prepare comprehensive motivations for inspection; - Obtaining appropriate authorisation; - Manage the inspection process from initiation to report stage and ensure that all important steps are covered. - Compile and present reports. • Enforcement of the Medical Schemes Act: - Ensure compliance with rulings and directives of the Registrar and the Council; - Implementation of enforcement intervention to ensure compliance with the MSA and related legislation; and - Monitor and make recommendations that help to strengthen governance systems of regulated entities. • Exemptions: To analyse exemption applications and make recommendations to Council. • Curatorship: To monitor curatorship and report continuously. • Stakeholder and Information Management: Develop and sustain information/intelligence networks with various institutions and individuals to manage compliance within CMS mandate. • Undertake assignments/tasks allocated by line manager in accordance with CMS’ operational requirements. • A degree in Law at NQF Level 8; and • A minimum of five (5) years’ experience in Forensic investigations and Compliance management of which one (1) year must be in private healthcare industry and two (2) years at supervisory or specialist level. • Knowledge of the healthcare and insurance industry; • Knowledge of legislation impacting on and influencing the functioning of the organisation; • Knowledge of contract evaluation and analysis; • Knowledge of handling evidence; and • Computer Literacy. • Knowledge of Criminal Procedure and Evidence; • Knowledge of commercial crime investigations; and • Report writing and presentation skills. SKILLS AND KNOWLEDGE BASE The successful candidate will have the following essential qualifications, competencies, and skills: Training and Knowledge areas: Technical Skills and Behavioural Attributes: If you are motivated, tenacious, thorough, accustomed to paying attention to detail and capable of working with a variety of projects simultaneously, you are welcome to send your application to recruitment@medicalschemes.co.zaand indicate on the subject line the position you are applying for. Note: Correspondence will be limited to shortlisted candidates only. If you do not hear from us within two (2) months of this advertisement, please accept that your application was unsuccessful. CMS reserves the right to appoint or not to appoint for the above position. Council for Medical Schemes is committed to the principles of employment equity. Closing date: Friday, 2 September 2022 CMS reserves the right to appoint or not to appoint for the above position. POPIA Disclaimer: Please take note that by responding to this advertisement and providing your personal information in application thereof, you confirm your expression and inform consent for CMS and all its subsidiaries and all affiliated entities to process your personal information; to retain your personal information on our database for future matching; to contact you when suitable opportunities arise; and that the information you have provided to us is true, correct and up to date.
The following position exists for the person driven by a desire to protect the public interest. SENIOR ANALYST: FINANCIAL SUPERVISION The purpose of the job is to monitor and regulate the overall financial soundness of medical schemes in line with the financial requirements of the Medical Schemes Act , through the analysis of financial information and provide guidance to subordinates. As a Senior Analyst you will be responsible for: · Taking responsibility for the day-to-day performance of the team and to provide feedback to the Senior Manager / to give support to the Senior Manager by outlining specific, shorter-term operational objectives, outputs, projects and processes of an entity. Developing and improving statutory returns system as tools for monitoring, the analysis of submitted data and the publication of report on findings in order to be responsive to the Council for Medical Schemes’ regulatory function and other financial and business requirements. · Improving quality of reporting by medical schemes by providing training, developing or reviewing and publishing standard guidelines, SAICA Accounting guide and IRBA Auditing guide. · Providing financial oversight over medical schemes; including conducting trend and ratio analysis, the evaluation of submitted business plans and continued monitoring. · Authorising and approving the appointment of auditors of medical schemes, as well as reinsurance arrangements in line with the Medical Schemes Act. · Providing specialised advice in respect of inter alia exemptions, new medical schemes’ registrations, amalgamations, new benefit options’ registrations, annual contributions & benefits updates, steering committees, inspections, Board of Trustees training etc. · Undertake assignments/tasks allocated in line with CMS’ operational requirements. SKILLS AND KNOWLEDGE BASE The successful candidate will have the following essential qualifications, competencies, and skills: · BCom Honours Accounting or relevant equivalent at NQF Level 8; · Qualification as a Chartered Accountant (SA) will be an added advantage; · A minimum of 5 years’ overall relevant working experience; three (3) years of which must be in auditing articles and two (2) years at management or supervisory level; · Registration with a relevant professional body (e.g. SAICA or similar) will be an added advantage. Training and Knowledge areas: · Knowledge of the accounting, financial reporting, and auditing standards such as International Financial Reporting Standards (IFRS) and International Accounting Standards (IAS). · Knowledge of the various financial analysis/valuation methodologies. · Knowledge of the medical schemes industry and the National Health Insurance Bill (NHI) and evolving healthcare reforms in the country will be an added advantage. · Computer Literacy. Technical Skills and Behavioural Attributes: · Customer Centrism [emotional intelligence, interpersonal, presentation and communication (verbal and written)] · Analytical, attention to detail, problem solving and report writing · Coaching, mentoring and supervision · Project management and time management · Proficiency in accounting & auditing standards and principles · Advanced Excel If you are motivated, tenacious, thorough, accustomed to paying attention to detail and capable of working with a variety of projects simultaneously, you are welcome to send your application to recruitment@medicalschemes.co.za please indicate on the subject line the position you are applying for. Note: Correspondence will be limited to shortlisted candidates only. If you do not hear from us within two (2) months of this advertisement, please accept that your application was unsuccessful. CMS reserves the right to appoint or not to appoint for the above position. Council for Medical Schemes is committed to the principles of employment equity. CLOSING DATE: FRIDAY, 2 SEPTEMBER 2022 CMS reserves the right to appoint or not to appoint for the above position. POPIA Disclaimer: Please take note that by responding to this advertisement and providing your personal information in application thereof, you confirm your expression and inform consent for CMS and all its subsidiaries and all affiliated entities to process your personal information; to retain your personal information on our database for future matching; to contact you when suitable opportunities arise; and that the information you have provided to us is true, correct and up to date. The following position exists for the person driven by a desire to protect the public interest. LEGAL ADJUDICATION OFFICER The purpose of the job is to analyse, investigate and adjudicate complaints lodged against medical schemes and other regulated entities; monitor complaints trends and initiate appropriate interventions to ensure compliance with the Medical Schemes Act (MSA), medical scheme rules and all other applicable laws. As a Legal Adjudication Officer you will be responsible for: · Investigation and resolution complaints in terms of the Medical Schemes Act. · Analysis of complaint responses from medical schemes and other regulated entities. · Collating evidence and applying relevant legal principles to complaints in order to make sound decisions. · Conducting research in relevant areas of law and health policy and apply same to the complaints. · Drafting binding decisions on behalf of the Office of the Registrar. · Providing clarity at the appeal hearings as and when required. · Drafting trends and non-compliance report for submission to the head of the unit. · Provide legal advice to complainants. · Represent the Complaints Adjudication unit in internal and external meetings. · Provide training to external stakeholders on scheme rules, the MSA & Regulations. SKILLS AND KNOWLEDGE BASE The successful candidate will have the following essential qualifications, competencies, and skills: · Bachelor’s degree in Law or relevant equivalent legal qualification at NQF Level 7. · A minimum of 3 years’ working experience of which 2 years must be in legal dispute resolution and legal research. Training and Knowledge areas: · Knowledge and understanding of the MSA, subordinate legislation, other relevant legislation, and case law; · Knowledge and understanding of interpretation of statutes; · Knowledge of and an ability to apply legal principles and case law to resolution of disputes; · Sound knowledge of government policy affecting healthcare provision; · Knowledge of case management will be an added advantage; and · Computer Literacy. Technical Skills and Behavioural Attributes: · Analytical and attention to detail; · Proficiency in technical and professional skills (Legal Drafting, Legal Research, Investigation, Interpretation of statutes); · Customer centrism, interpersonal and communication (verbal & written), presentation and report writing; · Problem solving and conflict management; and · Time and project management. If you are motivated, tenacious, thorough, accustomed to paying attention to detail and capable of working with a variety of projects simultaneously, you are welcome to send your application to recruitment@medicalschemes.co.zaplease indicate on the subject line the position you are applying for. Note: Correspondence will be limited to shortlisted candidates only. If you do not hear from us within two (2) months of this advertisement, please accept that your application was unsuccessful. CMS reserves the right to appoint or not to appoint for the above position. Council for Medical Schemes is committed to the principles of employment equity. CLOSING DATE: FRIDAY, 2 SEPTEMBER 2022 CMS reserves the right to appoint or not to appoint for the above position. POPIA Disclaimer: Please take note that by responding to this advertisement and providing your personal information in application thereof, you confirm your expression and inform consent for CMS and all its subsidiaries and all affiliated entities to process your personal information; to retain your personal information on our database for future matching; to contact you when suitable opportunities arise; and that the information you have provided to us is true, correct and up to date. The following position exists for the person driven by a desire to protect the public interest. EXECUTIVE: MEMBER PROTECTION (5 YEARS FIXED-TERM CONTRACT) To lead the development and implementation of the Member Protection objectives and functions of the CMS to ensure that members and beneficiaries of medical schemes are protected, serviced, and enabled. You will work within the Council for Medical Schemes and report to the Chief Executive & Registrar. You will be responsible: • To lead and coordinate the development of the strategic plan, annual performance plan, and operational plans of the different Member Protection sub-divisions to ensure statutory reporting within set deadlines; • To ensure alignment of strategy and budget allocations on an ongoing basis; • To manage, monitor, and take accountability for performance of Complaints Adjudication, Customer Care, Clinical Consulting Services, and Education & Training; • To act as a professional advisor to the Council on all relevant matters on an ongoing basis; • To develop, review and recommend changes to policies and implementation procedures for the approval to the relevant stakeholders as appropriate on an ongoing basis; • To manage sub-ordinates on an ongoing basis within key deadlines according to their KPA’s and KPI’s; • To liaise with external stakeholders and to develop strategic relationships to inform CMS strategy on an ongoing basis within key deadlines; • To build and maintain long term relationships with expert support panels to ensure improved quality of service to meet company objectives on an ongoing basis; • To ensure the active engagement with stakeholders on issues affecting the medical schemes environment and our regulatory function through industry advisory committees on an ongoing basis; • To ensure compliance with internal financial controls and the PFMA in the area under your control on an ongoing basis; • To tie strategic objectives of the CMS to annual and medium-term budget proposals; • Oversee and account for the management of audit activities effectively across Member Protection division; • Oversee and account for the effective and efficient budget management activities within the division; • Oversee and account for the management of effective and efficient risk management activities; • To ensure daily optimum utilisation and improvement of the Human, Information and Organisational capital in your functional area to improve the Organisation’s utilisation of its Human, Information and Organisational resources; and • To perform any additional responsibilities or tasks according to specifications as and when required. Skills and Knowledge Base – The successful candidate will have the following key competencies and skills: • Master’s degree qualification in Public Health or Legal or Business Management; • A minimum of 15 years’ overall experience, of which 5 years must be in a Senior Management role; 5 years in Complaints Management and 5 years in Private or Public health services; • Sound knowledge of strategy and policy formulation; • Knowledge of SAQA frameworks and Consumer Act/ Rights; • SA’s healthcare financing and delivery system, product knowledge and pricing; • Knowledge of Medical Schemes Act and Healthcare environment; • Knowledge of ethics and corporate governance; • Knowledge of business risks and mitigation strategies; • Knowledge of all related legislation impacting and influencing the functioning of the organisation (MSA, PFMA, BBBEEA, LRA, EEA etc.); • People management, financial and project management skills; • Excellent communication skills, complaints resolution skills; • Attention to detail, analytical skills, and ability to handle pressure; • Ability to motivate and influence others; and • Computer literacy. If you are motivated, tenacious, thorough, accustomed to paying attention to detail and capable of working with a variety of projects simultaneously, you are welcome to send your application to recruitment@medicalschemes.co.zaand indicate on the subject line the position you are applying for. Note: Correspondence will be limited to shortlisted candidates only. If you do not hear from us within two (2) months of this advertisement, please accept that your application was unsuccessful. CMS reserves the right to appoint or not to appoint for the above position. Council for Medical Schemes is committed to the principles of employment equity. Closing date: Friday, 2 September 2022 CMS reserves the right to appoint or not to appoint for the above position. POPIA Disclaimer: Please take note that by responding to this advertisement and providing your personal information in application thereof, you confirm your expression and inform consent for CMS and all its subsidiaries and all affiliated entities to process your personal information; to retain your personal information on our database for future matching; to contact you when suitable opportunities arise; and that the information you have provided to us is true, correct and up to date.
The following position exists for the person driven by a desire to protect the public interest. ANALYST: FINANCIAL SUPERVISION The purpose of the job is to monitor and regulate the overall financial soundness of medical schemes in line with the financial requirements of the Medical Schemes Act, through the analysis of financial information. As an Analyst you will be responsible for: • Reporting by medical schemes (Data Quality) - Improve quality of reporting by medical schemes by providing training, developing/reviewing, and publishing standard guidelines, SAICA Accounting Guide and IRBA Auditing Guide. • Statutory return (tools for monitoring and publishing reports on findings) - Develop and improve statutory returns as tools for monitoring, the analysis of submitted data and the publication of reports on findings and to develop tools that are responsive to regulatory and other financial and business requirements. • Financial oversight of Medical Schemes/Close Monitoring - Provide financial oversight of medical schemes; this includes trend and ratio analysis, the evaluation of submitted business plans and continuous monitoring. • Governance and Independence - Authorise and approve the appointment of auditors of medical schemes as well as reinsurance arrangements in terms of the Medical Schemes Act. • Provide financial advice - Provide specialised advice in respect of; inter alia, exemptions, registration of new medical schemes, amalgamations, new benefit options, contributions & benefits, steering committees, inspections, and Board of Trustees training. SKILLS AND KNOWLEDGE BASE The successful candidate will have the following essential qualifications, competencies, and skills: • BCom Degree/ Advanced Diploma/ BTech in Accounting or a relevant equivalent qualification at NQF Level 7. • A minimum of 3 years’ financial services experience. • Auditing experience will be an added advantage. Training and Knowledge areas: • Knowledge of the various financial analysis/valuation methodologies. • Knowledge of the accounting, financial reporting, and auditing standards such as International Financial Reporting Standards (IFRS) and International Accounting Standards (IAS). • Knowledge of relevant legislations (PFMA, MSA, POPIA, etc.) • Knowledge of basic interpretation of legislation. • Knowledge of basic project management. • Knowledge of the medical schemes industry will be an added advantage. • Computer Literacy. Technical Skills and Behavioural Attributes: • Interpersonal and communication (verbal and written); • Advanced Excel; • Presentation and reporting writing; • Analytical, attention to details and problem solving; • Customer centrism; and • Proficiency with Accounting Standards and Principles. This position is based in Centurion, Pretoria. If you are motivated, tenacious, thorough, accustomed to paying attention to detail and capable of working with a variety of projects simultaneously, you are welcome to send your application to recruitment@medicalschemes.co.za please indicate on the subject line the position you are applying for. Note: Correspondence will be limited to shortlisted candidates only. If you do not hear from us within two (2) months of this advertisement, please accept that your application was unsuccessful. CMS reserves the right to appoint or not to appoint for the above position. Council for Medical Schemes is committed to the principles of employment equity. CLOSING DATE: FRIDAY, 2 SEPTEMBER 2022 CMS reserves the right to appoint or not to appoint for the above position. POPIA Disclaimer: Please take note that by responding to this advertisement and providing your personal information in application thereof, you confirm your expression and inform consent for CMS and all its subsidiaries and all affiliated entities to process your personal information; to retain your personal information on our database for future matching; to contact you when suitable opportunities arise; and that the information you have provided to us is true, correct and up to date. The following position exists for the person driven by a desire to protect the public interest. ANALYST: ADMINISTRATOR ACCREDITATION The purpose of the job is to ensure that administrators are properly accredited and monitored, and that self-administered schemes comply with the administration requirements. As an Analyst Administrator: Accreditation you will be responsible for: · Administer and manage the accreditation process from start to finish of administrators and self-administered schemes in compliance with MSA, related regulations and the accreditation standards; by performing evaluations and analysis of new applications and the renewal of applications. · Conduct on-site evaluations of administrators and self-administered schemes’ resources, skills, infrastructure & capacity, and compliance with the accreditation standards. Prepare reports for consideration by the Steering Committee and Council. · Evaluate responses to accreditation conditions imposed and ensure accreditation of administrators and compliance with conditions by self-administered schemes is maintained in line with compliance initiatives. · Monitor financial soundness of all accredited administrators by ensuring submission of annual financial statements after financial year end and conducting an analysis thereof · Investigate complaints and render assistance to the Complaints Adjudication Unit with regards to investigating and resolving of complaints against accredited third-party administrators. SKILLS AND KNOWLEDGE BASE The successful candidate will have the following essential qualifications, competencies, and skills: · Honours/Post-graduation qualification in Accounting or Auditing or relevant equivalent qualification at NQF Level 8; · A minimum of a minimum of 3 years’ experience in Auditing/Accounting with SAICA Auditing articles completed; Training and Knowledge areas: · Knowledge of audit and accountings standards; · Knowledge of relevant legislation impacting the work of the organisation (e.g. MSA, FSR, POPI, PFMA, PAIA, CPA etc.) · Financial management knowledge; · Knowledge of the medical schemes or health care environment will be an added advantage; · Training on SAICA audit articles; and · Computer Literacy. Technical Skills and Behavioural Attributes: · Task and project management; · Auditing and proficiency in auditing tools; · Critical thinking and attention to detail; · Presentation and report writing; and · Interpersonal, interviewing and communication skills (verbal and written). If you are motivated, tenacious, thorough, accustomed to paying attention to detail and capable of working with a variety of projects simultaneously, you are welcome to send your application to recruitment@medicalschemes.co.zaplease indicate on the subject line the position you are applying for. Note: Correspondence will be limited to shortlisted candidates only. If you do not hear from us within two (2) months of this advertisement, please accept that your application was unsuccessful. CMS reserves the right to appoint or not to appoint for the above position. Council for Medical Schemes is committed to the principles of employment equity. CLOSING DATE: FRIDAY, 2 SEPTEMBER 2022 CMS reserves the right to appoint or not to appoint for the above position. POPIA Disclaimer: Please take note that by responding to this advertisement and providing your personal information in application thereof, you confirm your expression and inform consent for CMS and all its subsidiaries and all affiliated entities to process your personal information; to retain your personal information on our database for future matching; to contact you when suitable opportunities arise; and that the information you have provided to us is true, correct and up to date.
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