Location: Centurion, Gauteng

About the Health Policy Unit

The Health Policy Unit ensures evidence‑based, compliant, and sustainable clinical policy governance. The team develops clinical policies, conducts HTAs, oversees coding standards, and leads multidisciplinary decision‑making to support consistent, defensible coverage decisions.

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.

Essential Requirements

• Matric
• BPharm degree (minimum requirement)
• Completed Internship and Community Service
• Registration with the Pharmacy Council
• 3–5 years pharmacy retail / biotech / biomedicine experience
• Knowledge of ethical and surgical pharmaceutical products
• Proficiency in MS Office
• Knowledge of relevant pharmacy legislation (Pharmacy Act, Good Pharmacy Practice, Medicines Control Act 101 of 1965)

Advantageous Requirements

• Managed healthcare experience
• Strong understanding of medical aid scheme benefits, regulations, and formularies

Key Responsibilities

• Conduct Drug Utilisation Reviews (DUR) to assess medicine‑use patterns and ensure safe, effective, and cost‑efficient prescribing.
• Identify high‑risk or inappropriate medicine use and promote adherence to evidence‑based guidelines.
• Analyse utilisation trends and recommend interventions to reduce unnecessary pharmaceutical spend and improve quality of care.
• Contribute to the development and maintenance of evidence‑based managed care protocols and authorisation criteria.
• Support accurate alignment with Prescribed Minimum Benefit (PMB) legislation, including correct coding and interpretation of benefit rules.
• Assist teams with complex PMB queries and help mitigate regulatory risk.
• Support formulary reviews, pricing analysis, and utilisation monitoring to drive medicine-related cost optimisation.
• Identify pharmaceutical cost drivers and assist in implementing cost‑containment or value‑based initiatives.
• Engage constructively with pharmacies, clinicians, and provider groups to promote rational prescribing aligned with clinical protocols.
• Monitor clinical and operational indicators to identify gaps in medicine‑use quality, utilisation patterns, and adherence to policy.
• Support continuous quality improvement initiatives and contribute insights to policy updates, governance processes, and operational workflows.

The successful candidate must demonstrate the following competencies:

• Accountability
• Action‑oriented
• Customer focus
• Communication skills
• Resilience
• Trust-building
• Strategic mindset
• Self‑awareness
• Tech savvy
• Results-driven
• Problem-solving
• Values differences

Note: Company reserves the right to close the advert before specified closing date.