Pharmacist - Talentpool

Discovery Care

Pharmacist

About Discovery

Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders, Discovery is passionate about innovating in order to not only achieve financial success, but to ignite positive and meaningful change within our society.

About Discovery Care

Discovery Care, a subsidiary of Discovery Health, comprises of several specialized clinical areas with segmented teams. The Chronic and PMB Management team handles the processing of Chronic and Prescribed Minimum Benefit requests and manages escalated clinical queries. The HIV/Oncology and In-Hospital Case Management teams review clinical cases specific to their areas of expertise. The High Touch team provides hands-on services and resolves escalated queries for sensitive cases. Additionally, the Hospital Benefit Specialists, as part of field force, are responsible for real-time risk management and the Care Coordination Services manages the Managed Care programs.

Key Purpose:

To accurately assess CIB applications, in line with CIB products and in accordance with benefit entry criteria and established protocols.

Key Outputs:

The successful candidate will be responsible for but not limited to:

• Maintain acceptable daily turnaround times in accordance with CIB Quality standards

• Apply government stipulations in terms of PMB’s and treatment algorithms

• Identify and review cases falling outside of CIB protocols

• Receive and process inquiries from providers related to adding/amending medication

• Manage Chronic appeals process

• Call centre and operational support

• Make outbound calls to obtain or confirm clinical information from providers and members

• Interpret bulk data imports according to DH protocols and clinical criteria.

• Review requests for unregistered medication

Competencies:

The successful candidate must demonstrate the following competencies:

Education and Experience:

The following requirements are essential:

• B. Pharm.
• Registered with South African Pharmacy Council (SAPC).
• 3 Years retail or courier pharmacy experience post Community Service.

The following requirements are advantageous:

• The following requirements are advantageous:
• Understanding of DH product and benefits
• Understanding of DH funding and policies