Manager Specialist Claims

2 weeks ago

Johannesburg, Gauteng, South Africa Old Mutual Full time

Description

To effectively oversee the management in the Specialty Claims area and ensure the containment of spend, oversee strategic initiatives, claims, and risk strategies, effectively manage the use of the Specialty Claims Policy, setting and monitoring of Standard Operating Procedures to facilitate evidence based decision-making and achievement of departmental Key Performance Indicators. Provide excellent service in setting a culture of best practice within mandated responsibility.

Competencies

Critical objectives and responsibilities

Strategic Customer Collaboration Leading with Influence Innovation Personal Mastery Executing

Plan for, implement and manage the Claims Strategic Plan within designated area

Ensuring daily settlements are processed Ensuring monthly estimates are reviewed Ensuring recoveries and salvage monies due are received

Effectively manage the use of the Specialty Claims Policy, to facilitate evidence-based decision-making primarily within, but not limited to, the claims area based on best practice and promoting excellent service within mandated area of responsibility.

Review/produce Business reports Ensure continuous improvement on Standard Operating Process Benchmark Specialty Claims to market best practice Estimate audits, claims mandate audit is completed and corrective action is taken Monitor, track and update the claims division strategy to ensure execution and delivery. Design, manage and implement a Claims risk Strategy. Perform risk identification and risk evaluation/ assessment activity on risks at strategic, operational and process level. Oversee the delivery of the strategic projects and savings. Review claims best practice across all areas by doing the necessary industry research. Oversee monitor and track all issues arising from Internal and External Audits to ensure all management actions are implemented. Ensure complete and accurate management information is provided to all key Claims stakeholders and adequate monitoring mechanisms are designed/implemented to ensure timeous action is taken. Provide the relevant Reporting for the claims division weekly, monthly and quarterly as required. Conduct proactive Data analysis to identify trends, concerns and issues. Ensure that all information needs are determined, and enhancements are implemented to align with strategic objectives. Oversee the claims division communication internally and externally Oversee and Monitor Claims complaints, client, and broker surveys

Best-practice Service Delivery

Actively implement and monitor service practices to determine the status of customer service and relations

Proactively identify and implement changes required in customer service and relations

Develop customer solutions (process. products and systems) to address changing service requirements, implement customer centric strategies and ensure customer satisfaction

Manage effective SLA's with internal and external stakeholders

Provide professional services: where expectations are managed

Continuous improvement to ensure optimization and best practice

Streamline and integrate existing business processes and systems

Keep up to date with Best Operating Practice

Identify, prioritise, develop business cases for, present and execute Best Operating Practices

Create collaborative relationships with other departments to determine internal and external process improvements designed to enhance the customer experience and value

Optimise departmental performance through targeted business intelligence to ensure that it becomes the primary way of driving performance and execution

Evaluate and implement new systems and best operating practices

Best-practice people practices

Demonstrate direct leadership – be on the "office floor" frequently enough for personal contact to be real and significant, and to provide a role model to the team

Empower emerging leaders and specialists to achieve technical excellence and innovation

Define and benchmark competitive performance measures

Create an aligned balanced scorecard of operational measures in order to optimally mange performance

Ensure the department, section or specialist function is adequately resourced and has recruitment, retention and HR development plans in place

Ensure that all the team members consistently discharge their duties

Implement and manage a Development plan that ensures that the department has the human resources and skills required to deliver on the strategy for the short, medium, and long term

Identify, attract, appoint, grow, engage, reward, and retain top talent to drive operational execution

Manage poor performance constructively and decisively

Demonstrate leadership behaviour of personal involvement, commitment, and dedication to the business area in support of the organisations culture

Communicate a meaningful operational context to apply people best practice, fostering an environment of continuous learning and improvement

Identify, define, communicate, and obtain buy-in for performance expectations through the implementation of the chosen Old Mutual Insure performance management system

Ensure mechanisms are implemented to support major changes to the function by acting as a change agent

Create a collaborative environment which allows for employees with a functional area to work together, thereby leveraging constructive team dynamics and innovation

Ensure the work environment enables employees to "live" the organisations culture and values

Actively participate in own professional development and career path

Financial and corporate governance to ensure cost efficiency

Contribute to the development and implantation of fit for purpose budgets

Budget for weighing up costs and risks pertaining to workforce, technology, materials, and equipment used

Effective budgetary compilation and control

Manage vendor relationships and budgets

Keep within budget constraints for an annual period, monitor planned vs actual, and report on cost efficiency

Take accountability for the management of business-related risks within own area

Operate within agreed mandates as documented in the business rules

Experience, knowledge & skills required

Relevant degree in business and/ or finance Fellowship/ Associateship with the IISA or FCIISA preferred Management qualification an advantage 5 Years relevant experience of which at least 3 years should have been in a management capacity/ leadership role

Skills

Education

Closing Date

03 June 2024

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