Medical Scheme Senior Operations Manager

6 months ago

Pretoria, South Africa Careforce Recruitment Full time

Our client, a managed care organisation in Pretoria are currently looking for a

**Senior Manager: Operations. **Thisis an equal opportunity oganisation with various businesses and/ or subsidiaries that service clients in the medical scheme and insurance industries.

**Reporting to**: Dual reporting role to both Chief Executive Officer and General Manager

**Location**: Head Office Pretoria (on-site)

**Contract Type**: Fixed Term Contract for period of 12 months (with possibility of becoming permanent thereafter)

**Salary**: Subject to experience market related CTC package that includes medical scheme and provident fund

**Purpose of the position**

To provide leadership and manage various operational teams to ensure the achievement and maintenance of service levels across all functional areas of service delivery. The successful incumbent must be able to translate the business strategy into the business operations through the effective use and implementation of best practices principles; setting and achieving company objectives and individual staff goals; and the analyses and interpretation of various operational processes and workflow metrics to continuously and pro-actively ensure service delivery improvement.

**Summary of Responsibilities and Duties**:

- Ability to implement business objectives and strategies
- Daily monitoring of team targets/duties/performance
- Identify, prioritise and pro-actively allocate resources to the operational need
- Be the conduit for daily operational communication
- Participate in developing performance plans, set goals and objectives
- Ensure a balanced allocation of supporting resources
- Manage expenditure in terms of over-time work against performance targets
- Liaise with relevant stakeholders to gather information and to effectively attend to and resolve operational needs
- Ensure all relevant communications and data are updated and recorded
- Set performance targets for speed, operational efficiency, accuracy and quality in service delivery to maintain contracted service levels.
- Establish and measure success in meeting goals, objectives and service level adherence
- Review the performance of staff, identify training needs and plan knowledge transfer and training sessions in collaboration with the HR department
- Record statistics, user rates and the performance levels of various teams as well as individual staff members
- Undertake needs assessments, performance reviews and cost/benefit analyses
- Prepare reports on the statistics, rates and performance levels
- Presentation of reports to Rx Group Executive Management as well as other key stakeholders, such as contracted medical scheme clients
- Personally attend to the most complex customer complaints or enquiries and provide timely and accurate feedback. Where required, involve other key stakeholders or Executive Managers
- Interpret, communicate and ensure implementation of all company policies, procedures and, where relevant, client schemes’ clinical protocols and funding guidelines.
- Maintain up-to-date knowledge of industry developments
- Mentor, coach, motivate and retain staff
- Coordinate staff recruitment and liaise with HR department

**Qualifications and experience**
- Bachelor’s degree in business administration or similar
- Minimum 10-years’ experience within the services industry, of which at least 5 years should be in a leadership/ management role.
- Relevant legal and statutory knowledge i.e. BCEA, Medical Scheme’s Act, POPIA, LRA etc.
- Knowledge of medical scheme services including but not limited to provider claims payment, pre-authorisation processes and Council for Medical Scheme’s complaints resolution will be advantageous.
- Experience in process re-engineering to achieve improved service levels and client satisfaction ratings, making critical decisions and exploiting opportunities for efficient operations.
- Experience in all aspects of Industrial Relations.
- Demonstrated ability to foster a team-orientated and interconnected work environment.
- Valid driver’s license.

**Other Skills and Competencies**
- Critical reasoning and decision-making skills
- Ability to manage high levels of pressure, demands and emotionally charged situations and to make sound decisions
- Excellent communicator and people skills
- A hands-on approach
- Foster teamwork
- Proficient with MS Office (Power Point, Excel, Word, Outlook)
- Excellent verbal and written communication skills in English
- High degree of accuracy and attention to detail
- Administration and reporting skills

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