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Large Corporate within managed healthcare is recruiting for a General Manager - Group Legal, Risk and Compliance (Healthcare - Medical).
To spearhead the legal, risk and compliance function for the company. To support the various business units of the company which include medical scheme administration, managed healthcare, healthcare claims switching and processing, corporate and occupational health and wellness services, health insurance products, broker services, alternative healthcare payment products as well as Group IT, HR and Finance support services.
Duties & Responsibilities
Legal support for the company:
Maintenance of contract and other legal documentation indexing system and repository for the company.
Drafting/ vetting of various types of contracts, NDA's and other documentation requiring legal expertise for the company (currently there is an external consultant in place that supports the company with the drafting/ vetting of certain specialised contracts pertaining to healthcare, healthcare IT and intellectual property). This support will include but not be limited to:
Drafting of contracts using company templates and advising thereon,
Drafting of addedums or extensions to existing contracts
Preparation of standard NDAs on the company's templates
Drafting of independent contractor/ consulting agreements
Vetting of basic contracts, credit applications and terms and conditions e.g. cleaning contracts, lease agreements, vendor applications, etc.
Vetting of IT Vendor contracts
Vetting of service provider agreements
Roll-out of companies hospital claims processing contract to all private hospital clients
Roll-out of companies doctor claims processing contract to all doctor clients
Diary management and follow up to ensure that contracts are signed and critical matters have been attended to.
Accurate and relevant advice to fund Managers and operational areas on changes to client application forms, scheme rule changes, CMS complaints, customer complaints etc.
Attending to draft and respond to correspondence that require legal input
Member of the companies Audit and Risk Committee
Participation in the companies Combined Assurance (Risk Management) Forum
Drafting/ vetting of policies and Standard Operating Procedures (SOP's), including company formal quality management system support by reviewing and signing off on SOP's (ISO 9001) with legal risk implications
Attendance of and participation in internal IT Security Committee meetings
Liaison with various jurisdictions company secretaries
Initiating, drafting, maintenance, training and awareness of various internal governance policies and procedures
Knowledge and understanding of King IV and international best practice
Drafting of board minutes or resolutions
Carry out any other ad-hoc duties required by the company from time to time
Generally, assist and support the Group CEO, CFO and Group Legal, Risk and Compliance Consultant
Desired Experience & Qualification
B.Comm Law/ LLB/ LLM degree or similar qualification
Admission as an Attorney to the High Court of the Republic of South Africa
Minimum of 10(ten) years' experience in legal, risk and compliance in the medical scheme/ healthcare insurance environment essential
Industry proven track record of managing a legal, risk and compliance department
Exposure to healthcare legislation is essential
Exposure to information technology contracts will be a distinct advantage
Knowledge and understanding of the current developments within the healthcare insurance environment including the demarcation regulations will be a distinct advantage
Knowledge and understanding of alternative banking payment systems and processes will be a distinct advantage (mediBucks)