Project Manager – Managed Care Contractor Implementation (Hybrid, Fixed Term)

Role Purpose We are seeking a seasoned Project Manager to lead the implementation and integration of a new managed care contractor for our medical scheme. This role is critical to ensure the smooth transition and seamless interfacing between the new contractor and existing third-party service providers, including Hospital Benefit Management, Pharmacy Benefit Management, and Disease Management. The role also includes responsibility for data sharing and integration with our internal Data Warehouse. Key Responsibilities Project Planning & Governance Develop a detailed implementation roadmap and timeline for the contractor onboarding process. Establish project governance structures, reporting protocols, and decision-making frameworks. Define key milestones, deliverables, and dependencies. Stakeholder & Vendor Management Act as the primary liaison between WCMAS, the new managed care contractor(s), and existing third-party service providers. Facilitate coordination across business units, including IT, Clinical, Finance, and Member Services. Ensure contractual obligations and integration points between vendors are clearly defined and delivered. Data Integration Oversight Coordinate requirements gathering for data exchange formats and frequency with the contractor. Oversee the development and testing of data interfaces to the WCMAS Data Warehouse. Work with IT teams to ensure compliance with security, privacy, and interoperability standards (e.g., POPIA, HL7, etc.). Risk Management Identify risks and develop mitigation plans, particularly those affecting member experience, benefit continuity, or compliance. Manage change control and ensure minimal disruption during contractor handover. Reporting & Communication Provide regular progress reports to the Executive and relevant governance bodies. Prepare executive summaries, dashboards, and stakeholder updates. Escalate issues that threaten timelines, budgets, or quality. Qualifications & Experience Bachelors degree in Health Sciences, Business Administration, IT, or related field. Project Management Certification (e.g., PMP, Prince2, Agile PM) is mandatory. Minimum 810 years of project management experience, ideally in healthcare, insurance, or managed care environments. Demonstrated experience managing multi-vendor integrations and data migrations. Strong knowledge of South African medical schemes, healthcare legislation, and third-party administrator operations. Key Competencies Excellent stakeholder engagement and interpersonal skills Proven leadership in cross-functional team environments Strong analytical and problem-solving abilities High attention to detail and structured approach to delivery Ability to work under pressure and manage multiple priorities Familiarity with healthcare data standards and regulatory requirements

Location: Emalahleni MP, ZA

Posted Date: 6/11/2025