Senior Clinical Governance Specialist

About the role

The Senior Clinical Governance Specialist provides expert clinical insight and oversight to protect the clinical, ethical, reputational and financial integrity of the Scheme. Reporting to the Chief Medical Officer and CFO, the role ensures that all healthcare services, procurement initiatives and funding policies align with evidence‑based medicine, corporate governance and cost‑containment goals.

Key responsibilities

• Support the Chief Medical Officer in executing the Scheme’s clinical governance strategy and chairing the Clinical Governance Committee.
• Monitor, evaluate and provide clinical oversight for strategic risk‑management initiatives, including value‑based care, wellness and disease‑management programmes.
• Review clinical and funding policies to ensure alignment with global evidence‑based guidelines and health‑economics principles.
• Provide clinical analysis for procurement of services, medical technologies and pharmaceuticals, drafting and evaluating bid specifications for RFPs/RFQs.
• Oversee provider contracting and Service Level Agreement compliance, managing conflicts of interest and ensuring clinical outcomes meet contractual standards.

Required profile

• Minimum 5‑6 years post‑qualification clinical experience in a medical, managed‑care or complex hospital environment.
• Proven exposure to clinical procurement processes, provider contracting or medical‑scheme fund management.
• MBChB (or MBBCh) degree with active HPCSA registration; postgraduate qualification in Public Health, Health Economics, Healthcare Management, Clinical Governance or Medical Audit is preferred.
• Code 8 driver’s licence, own transport and ability to work extended hours in a hybrid home‑office setting.
• Strong understanding of South African clinical procurement frameworks, managed‑care principles and relevant legislation (Medical Schemes Act, POPIA, King IV/V).

Required skills

• Clinical Data Analysis
• Contract & SLA Interpretation
• Commercial & Financial Acumen
• Administrative Independence