About the Position

Experience in similar position with Medical Aid Scheme or Medical Aid Scheme Administrator – Non-Negotiable

Our client, in Managed Care (Medical Scheme Sector), seeks a Claims Manager who will be responsible to ensure medical scheme administration tasks operate at optimal efficiency and are cost effective. Responsible for ensuring excellent services exceeding expectations.

Requirements:

• BCom Degree or related BAdmin Degree – (Non negotiable)
• Postgraduate qualification in business administration – preferred
• Minimum 3 – 5 years experience in managing medical scheme functions at management level
• Manage daily claim functions, ensuring medical scheme and health insurance processes are at required optimal levels
• Manage, review, update and implement projects, ensuring operations efficiency and cost savings on all levels regarding system, processes, people enhancements etc.
• Capable of translating and aligning strategic intent relevant to departments into operational goals
• Managing performance management processes, achieving departmental and divisional goal achievements
• Manage, motivate and up-skill the membership teams, developing and growing the teams through training
• Liaising with management on various levels across the organisation to align, improve and integrate business processes and service delivery
• Create, lead and organised, high-performance culture within the claim teams
• Continuously monitor, analyse and improve the claims business processes and performance
• Lead business optimization, ensuring maximize profitability
• Ability to be innovative, adoption of technology, creating a sustainable and lucrative business
• Cost management – substantial costs are linked with operations, managing operations cost is a key aspect
• Review and set department budgets and managing the cost
• Part take in identifying new business ventures and preparation for tenders
• Ensure all employees on various levels have clarity on delivery of their service expectation and a understanding of their contribution in their various roles to ensure favorable business operational success
• Supervise the compliance with audit control system procedures and policy, ensuring to comply with legal requirements, ensuring to meeting safety standards
• Partake in specialized projects and assignments, taking on additional management responsibilities as and when required
• Manage and implement the optimization of reporting within claims department
• Able to avail yourself for after hours and weekend work as per business requirements as and when needed

Submit CV application with supporting documents:

• Copy of ID
• Copy of qualification(s)

Desired Skills

Desired Qualification Accreditation