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Location: Centurion, Gauteng
Position Purpose: To identify, investigate, and assist in the prevention of fraud, waste and abuse within the medical aid environment. This includes but is not limited to analysing healthcare provider claims, member behaviour and internal operations to mitigate financial and reputational risks… find out more
Location: Centurion, Gauteng
Position Purpose: To lead and manage a team of professionals responsible for hospital pre-authorisations and/or case management, ensuring accurate, clinically appropriate, and cost-effective decision-making. The role ensures adherence to clinical guidelines, medical necessity criteria, and effective clinical risk management, while optimizing patient outcomes and resource utilization… find out more
Location: Centurion, Gauteng
Position Purpose: To provide administrative and operational support to the Medical Advisory Unit by: coordinating clinical workflows, managing case administration, maintaining accurate records, and supporting Medical Advisors, Clinical Managers, and Clinical Care Coordinators in the administration of clinical reviews, ex-gratia requests, disputes, appeals, and managed care processes… find out more
Location: Centurion, Gauteng
Purpose: As an Oncology Care Coordinator, you will provide critical clinical support, patient navigation, and care coordination to beneficiaries undergoing oncology treatment. You will be a central point of contact for beneficiaries, assisting them through diagnosis, chemotherapy, radiation, surgery, and survivorship or palliative pathways. This role also requires effective management of clinical and operational queries, ensuring timely, accurate, and supportive responses to beneficiaries, providers, and internal teams… find out more
Locations: Centurion, Gauteng
Position Purpose: The Team Leader: Clinical Quality Assurance is responsible for leading and overseeing quality assurance audits and related activities to ensure high standards of care, regulatory compliance, and risk mitigation. The role focuses on transforming audit findings into actionable insights that drive quality improvement, reduce risk, and support sound governance… find out more
Location: Centurion, Gauteng
Position Purpose: Clinical Policy pharmacist supports pharmaceutical policy development, medicine‑use evaluation, and evidence‑based decision-making within the Health Policy Unit. The role ensures that clinical and coverage decisions related to medicines are safe, cost‑effective, compliant with legislation, and aligned with managed care principles. The pharmacist also provides technical support to policy specialists, HTA specialists, and pharmacist assistants… find out more
Location: Centurion, Gauteng
Position Purpose: The Legal and Compliance Advisor will provide strategic legal, regulatory, and compliance support across the Medical Advisory Unit (MAU), Health Policy Unit (HPU), and the broader administrator. The role will ensure regulatory alignment, strengthen governance and control, mitigate legal and compliance risk, and enhance member confidence through authoritative legal interpretation … find out more
Location: Centurion, Gauteng
Position Purpose: As the first point of contact for our stakeholders and clients, you will be instrumental in upholding our professional reputation. Your role is central to ensuring seamless front-office operations, providing essential administrative support, and overseeing facilities management to maintain an efficient workplace… find out more
Location: Centurion, Gauteng
Position Purpose: We are seeking a highly organised, professional, and detail-oriented Administrator to provide high-level administrative, secretarial, and coordination support to the Health Policy Unit (HPU). The successful candidate will play a critical role in ensuring efficient unit operations, strong governance processes, and effective stakeholder engagement within a dynamic healthcare policy environment… find our more
Location: Centurion, Gauteng
Position Purpose: To provide comprehensive administrative and coordination support to the fraud, waste and abuse team by ensuring efficient case management, accurate record-keeping and timely processing of documentation related to fraud, waste and abuse within the managed care organisation… find out more
Location: Centurion, Gauteng
Position Purpose: The Legal and Compliance Advisor will provide strategic legal, regulatory, and compliance support across the Medical Advisory Unit (MAU), Health Policy Unit (HPU), and the broader administrator. The role will ensure regulatory alignment, strengthen governance and control, mitigate legal and compliance risk, and enhance member confidence through authoritative legal interpretation, effective dispute resolution, and strong compliance oversight… find out more
Location: Centurion, Gauteng
Position Purpose: The Non-Disclosure Investigator is responsible for identifying and investigating suspected cases of member non-disclosure, misrepresentation, or omission of material medical information during the application process for medical scheme membership… find out more
Location: Centurion, Gauteng
Position Purpose: As a PLO, you will be the face of the organisation to healthcare providers, building strong relationships, resolving operational issues, supporting digital enablement, and ensuring providers understand and comply with network requirements. Your work directly strengthens provider satisfaction, improves member experience, and enhances the effectiveness of our provider network… find out more
Location: Centurion, Gauteng
Position Purpose: The Claims Team Leader is responsible for overseeing the daily operations of the claims processing team, ensuring that claims are assessed, processed, and paid accurately, efficiently, and in line with the policies, guidelines of the medical aid scheme and service level agreements (SLAs). The role also focuses on managing the financial risk associated with claims, enhancing the quality of service to members, and protecting the sustainability of the medical aid scheme… find out more
Location: Centurion
Position Purpose: To perform day-to-day configuration administration and monitoring of PHA’s core business systems within a managed care environment. The employee will analyse business requirements, document and implement configuration changes with precision, and ensure system integrity through structured quality assurance and governance practices… find out more
Location: Centurion, Gauteng
Position Purpose: The Onboarding Quality Controller & Underwriter ensures that members joining the medical scheme are onboarded accurately, efficiently and in compliance with regulatory requirements. This role safeguards data integrity, enhances member experience and supports operation excellence by monitoring and improving the quality of onboarding processes… find out more
Locations: Centurion, Gauteng
Position Purpose: To support the organization’s strategic objectives while maintaining compliance, efficiency, and employee satisfaction by providing effective administrative support across all HR functions… find out more
Location: Centurion, Gauteng
Position Purpose: To lead a team of clinical staff who manage clinical and financial risk of high-risk beneficiaries. Aiming at educating and supporting beneficiaries, promoting health-seeking behaviour and coordinating care with relevant family practitioners… find out more
Location: Centurion, Gauteng
Position Purpose: The Planner in Workforce Management (WFM) provides proactive, solutions-oriented support for the Contact Centre management and continuous improvement of workforce processes, policies and procedures. The four key components of workforce management are forecasting work volumes, calculating staffing needed, creating applicable schedules and monitoring real-time adherence for efficient contact centre operations. To minimise operational risks linked to poor staffing allocation and ensure all service channels remain stable, adequately resourced and aligned to business demand… find out more
Location : Centurion
Position Purpose: To ensure the accurate issuing of appropriate pre-authorisations that meets the
requirements of clinical appropriateness, medical necessity and clinical risk management… find out more
Location: Centurion, Gauteng
Position Purpose: To provide expert clinical assessment and decision making in relation to Ex gratia applications, regulatory (CMS) complaints, appeals, disputes and escalations… find out more
PHA has its head office in Centurion, Gauteng. It operates country-wide with a nationally linked network and uses a robust, flexible, as well as integrated system to ensure efficient and effective administration of membership and benefits.