Senior Clinical Risk & Appeals Leader

Private Health Administrators (Pty) Ltd is seeking a Senior Risk Manager to provide strategic leadership over the Medical Advisory Unit's clinical risk portfolio, including Appeals, Disputes, CMS complaints, and PMB regulatory escalations. The role ensures evidence-based, legally compliant, and ethically sound clinical decisions, partnering with Legal, Health Policy, and Clinical Operations to mitigate risk. J-18808-Ljbffr