Operations Manager: Disability Claims
2 weeks ago
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Overall purpose of the role:
- The Disability Claims Operations Manager is responsible for overseeing and leading the operations of multiple disability claims teams, ensuring the efficient and effective administration of claims in alignment with business objectives.
- This role focuses on driving process optimization, maintaining service excellence, and enhancing team performance while ensuring strict adherence to company policies, risk management frameworks, and regulatory requirements.
- Additionally, the Disability Claims Operations Manager plays a critical role in fostering stakeholder engagement, ensuring customer satisfaction, and leading continuous improvement initiatives to support the organization's strategic goals.
Key Responsibilities:
Operational Leadership and Efficiency
- Oversee and coordinate the operations of three New Claims Administration teams, one Review Administration team, one Adjustment (income payment) team, and three Senior Technical Specialists responsible for payment quality control and approvals.
- Ensure seamless execution of operational processes in alignment with company objectives, compliance requirements, and industry best practices.
- Monitor key performance indicators (KPIs), identify performance gaps, and implement corrective measures as needed.
- Manage workflow distribution and resource allocation to maintain service levels and optimize operational efficiency.
- Monthly and quarterly service level reporting.
Key Responsibilities Continues:
Driving Results Through People
- Lead, inspire, and develop team members to foster a culture of high performance, accountability, and collaboration.
- Conduct regular coaching, mentoring, and performance feedback sessions to build individual and team capabilities.
- Implement performance management frameworks to track progress, recognize achievements, and address performance challenges.
Customer Service Excellence
- Ensure efficient and accurate claims processing to deliver a positive customer experience.
- Drive the adoption of customer service best practices to enhance client satisfaction and retention.
- Proactively address and resolve customer concerns, ensuring effective escalation management and timely resolution of queries.
- Maintain and continuously improve service levels and turnaround times in line with SLAs and KPIs.
- Managing client and intermediary complaints, ensuring these are resolved within service levels.
Key Responsibilities Continues:
Performance Optimisation and Continuous Improvement
- Identify and implement process improvements to enhance efficiency, accuracy, and scalability.
- Develop and maintain reporting structures to monitor claims performance, identify trends, and assess risk exposures.
- Ensure compliance with internal policies, regulatory requirements, and industry standards to mitigate operational risks.
- Collaborate with internal stakeholders to drive cross-functional improvements and achieve shared business objectives.
- Manage the limited IT function within the team, ensuring system integration where required and in specifying new IT requirements.
- Promote a culture of continuous learning, innovation, and engagement to build a resilient and high-performing workforce.
Qualification and Experience:
- B. Comm or related tertiary qualification or an equivalent number of years of practical experience in a similar role.
- Previous management experience in disability claims operations or a related field.
- Sound knowledge of claims processes and procedures.
- Reasonable knowledge of group risk products, processes, and services within the Sanlam Employee Benefits environment would be advantageous
- Understanding of rules and policy regulations related to disability schemes and funds.
Knowledge and Skills:
- Proficiency in MS Office Suite (Excel, Word, PowerPoint, Outlook) for reporting and analysis.
- Strong leadership, coaching, and mentoring abilities.
- Exceptional communication and stakeholder management skills.
- Ability to identify risks and implement risk mitigation strategies.
- Strong problem-solving and decision-making capabilities.
- High attention to detail and a proactive approach to issue resolution.
- Ability to work under pressure and manage multiple priorities effectively.
Additional information:
- The role requires close collaboration with internal and external stakeholders, including clients, brokers, and various business units.
- Travel may be required for client meetings and operational engagements.
- The position plays a strategic role in driving customer-centric transformation initiatives.
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