Head: Claim Operations

2 weeks ago

Centurion, South Africa Affirmative Portfolios Full time

**Business Management ~ Communication**
**Centurion**
***:
**Head: Claim Operations - Centurion - Permanent-Salary: Market Related**

**Minimum Job Requirements**

**Qualification And Experience**
- Bachelor’s degree in business management / Business Administration / Medical / Health or related qualification.
- Post graduate qualification in Business Management / Business Administration or related qualification.
- At least 10-12 years’ relevant claims administration experience of which 5 (five) years must have been at a senior management level.
- Advanced knowledge in claims management systems, insurance/reinsurance principles and MVA legislation.
- Experience in the claims administration environment in the private and/or public sector.

**Competencies**

**Managerial**
- Change Management.
- Coaching and Mentoring.
- Conflict Management.
- Critical and Innovative Thinking.
- Direction Setting.
- Facilitating and Presentation Skills.
- People Management.
- Policy Conceptualisation and Formulation.
- Programme/Project Management.
- Risk Management.
- Service Delivery Innovation.
- Stakeholder Development and Relations.
- Reporting.

**Behavioural**:

- Strategic capability.
- Results Orientation
- Business and Financial Acumen
- Compliance and Governance
- Leadership Agility
- Resilience
- Communication
- Working with people
- Network and Alliances
- Planning, Organizing and Coordinating
- Employee Engagement
- Ethics and Values
- Client Service Orientation

**Technical**:

- Advanced knowledge of claims management systems.
- MVA legislation knowledge.
- Strong analytical, communication, leadership, managerial and organizational skills.
- Skilled in critical thinking, creativity in resolving unique and challenging business problems.
- Ability to do long-term planning, to create and manage budgets and to be a strategic thinker.
- Ability to achieve results by taking a proactive long-term view of business goals and objectives.
- Knowledge on continuous improvement/innovation and optimization methodologies.
- PFMA knowledge.
- Communication (Written and Verbal).

**Key performance Areas**

**Strategy development and operational planning**
- Lead the Implementation of the Claims Operations business strategy and plan that ensure alignment with short-term and long
- term objectives.
- Lead the implementation and annual review of the overall Strategic Plan for the Claims Operations department.
- Oversee and implement specific key performance indicators and measures against outcomes detailed in the departmental strategic plans as set out by the Executive.
- Provide strategic input into the plan of the current and future interventions necessary to achieve acceptable levels and standards of the organization strategy and operational plans to the Executive forum.

**Policy review and implementation**
- Provide direction on the development and implementation of policy, procedures, and processes.
- Work with appropriate structures to ensure effective execution of policy and practices.
- Provide advice and guidance to the Policy department on legislative compliance, emerging issues, risks and the implementation of changes required on policy matters.

**Claims administration**
- Provide strategic direction to ensure a complete and sound claim process (from initiation to close out phase), settlements, legal reviews, and investigations within 120 days target in accordance with the organization policies and procedures.
- Provide leadership in the interaction with customer experience function as the engine to maximising customer satisfaction within the claims process.
- Establish and maintain appropriate systems to perform claims processing, medical administration, and other claims related functions.
- Lead the development/design, implementation and maintenance of a self-service portal that will enable a smooth claims process and foster transparency for the end user.
- Oversee and provide direction in the interaction with claims risk function to ensure that claims merits are thoroughly assessed, and determination is based on accurate information.
- Oversee and monitor the direct execution of claims operation policies to support overall company policies and objectives.
- Demonstrate successful execution of business strategies for the organization products and services.
- Liaise with other departments to identify improvements in claims process and procedure.
- Provide leadership and oversight in all the interactions with the actuarial function to ensure claims are successfully paid out correctly and in time.
- Oversee the implementation of a successful claims mediation process to minimize litigation of a claim as much as possible.
- Manage the interaction with the Legal function to provide effective litigation and other legal services where necessary.
- Ensure claims activities at a high level, comply with organisational requirements for quality management, legal stipulations, and general duty of care.
- Ensure claims are mea

  • Head of Operations

    1 month ago

    Centurion, South Africa PSG Insure Full time

    **Job description**: The Head of Platform operations will **develop & implement operational policies and procedures, **developing strategies to **increase productivity and reduce costs** (through driving the Target Operating Model and Operational Workflow processes); The measuring, monitoring and improving company **operational efficiency** such as...

  • Claims Operational Manager

    4 weeks ago

    Centurion, South Africa CLC Full time

    **Job description**: To provide CLC as a business and the Claims Own Damage department with the necessary management and support in performing the claims processing duties within the SLA’s stipulated. This includes all claims processes and tasks as well as all communication relating to matters that impact all stakeholders. **Qualifications and...

  • Claims Consultant

    4 weeks ago

    Centurion, South Africa PSG Insure Full time

    **Job description**: The Claims Consultant is responsible for coordinating and overseeing, managing and negotiating the settlement of the claim. The consultant is accountable for finalising the claim end-to-end and must have knowledge of Commercial and Personal lines products and be able to process motor as well as non-motor claims **Responsibilities**: -...

  • Claims Assessor

    1 month ago

    Centurion, South Africa MMI Holdings Ltd Full time

    Closing Date2023/03/20Reference NumberMMH230301-6Job TitleClaims AssessorPosition TypePermanentRole FamilyClient ServicesClusterHealth SolutionsRemote OpportunitySome of the timeLocation - CountrySouth AfricaLocation - ProvinceGautengLocation - Town / CityCenturionIntroduction Metropolitan is one of the oldest financial services brands in South Africa. With...

  • Claims Assessor

    1 month ago

    Centurion, South Africa Momentum Life Full time

    **Introduction**Role Purpose** - To be part of a team that provides market leading claims assessment capability for living benefits (critical illness, income and disability benefits). This will include specialising in income disability, lump sum disability,critical illness and case management for living benefits, the completion of quality industry...

  • Claims Assessor

    4 weeks ago

    Centurion, South Africa Momentum Life Full time

    **Introduction** The Retail Life Insurance department is looking for a self-driven, dynamic health professional who wants to grow their career in Claims Assessment. Myriad is Momentum's market-leading life insurance product, providing lifecover to clients in South Africa. Our Myriad product aim in partnering with our clients on their journey to success. We...

  • Senior Manager: Claims Assurance

    1 month ago

    Centurion, South Africa Affirmative Portfolios Full time

    **Insurance ~ Risk Management** **Centurion** ***: **Position: Senior Manager: Claims Assurance - Centurion** **Location: Centurion** **Salary: R1,371,054.00pa CTC** **Overview**: **The Senior Manager: Claims Assurance** is responsible to over the provision of claims assurance function to ensure that company is protected from financial loss; reduction in...

  • Claims Consultant

    1 month ago

    Centurion, South Africa PSG Insure Full time

    **Job description** The Claims Consultant is responsible for coordinating and overseeing, managing and negotiating the settlement of the claim. The consultant is accountable for finalising the claim end-to-end and must have knowledge of Commercial and Personal lines products and be able to process motor as well as non-motor claims **Responsibilities**: -...

  • Junior Claims Consultant

    1 month ago

    Centurion, South Africa Momentum Life Full time

    **Introduction** **Role Purpose** Provide a support service to the claims department by liaising with clients/stakeholders and providing solutions. **Requirements**: Matric. Business related Diploma/Degree. 2-3 years exposure to the Life Insurance industry. Call Centre knowledge. Medical terminology preferred. **Duties & Responsibilities** Provide...

  • Incident Management Consultants

    1 month ago

    Centurion, South Africa Customer Loyalty Consultants (Pty) Ltd Full time

    **Gauteng**, Centurion** **R 10000 (Negotiable)** CLC is based in Centurion, Gauteng, and operates mostly within the Short-Term Insurance Industry. CLC is a dynamic and forward-thinking company committed to delivering excellence. As a leader in our field, we pride ourselves on innovation, professionalism, and a commitment to our clients' success. We are...

  • Incident Management Consultants

    3 weeks ago

    Centurion, South Africa Customer Loyalty Consultants Full time

    CLC is based in Centurion, Gauteng, and operates mostly within the Short-Term Insurance Industry. CLC is a dynamic and forward-thinking company committed to delivering excellence. As a leader in our field, we pride ourselves on innovation, professionalism, and a commitment to our clients' success.We are seeking Afrikaans speaking Incident Management...

  • Claims Manager: Building at Momentum Insure

    4 weeks ago

    Centurion, South Africa Momentum Insure Company Limited Full time

    **Introduction** **Role Purpose** To effectively manage personal lines claims, the processes, procedures, systems and people, in order to maximise gains, minimise losses and costs. **Requirements**: - Grade 12 (Matric) - Leadership or Management Qualification advantageous - At least 2 years’ of experience at a management level specifically in...

  • Head, Im Operations, Cc

    1 month ago

    Centurion, South Africa Exxaro Recruitment Full time

    **Job Advert Summary**: **PURPOSE**: - To take accountability of the relationship between The ConneXXion business functions and Information Management (IM). - Ensure that IM service offering is aligned to The ConneXXion business functions’ strategic needs. - Fulfil a significant role in ensuring alignment between business and IM through understanding...

  • Operations Lead

    1 month ago

    Centurion, South Africa AJ Personnel Full time

    **Main purpose of the job**: - To lead and support the operations activities that support the implementation of the CDC Gophelega Programme including physical and administrative office operations, fleet management, procurement, IT & HR support **Location**: - **Wits RHI - Regional Office - Riverside Office Park, Heuwel Road, Centurion** **Key performance...

  • Legal Consultant: Liabilities

    1 month ago

    Centurion, South Africa Momentum Insure Company Limited Full time

    **Introduction** Through our client-facing brands Metropolitan and Momentum, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. **Role Purpose** The Legal Consultant:...

  • Intermediate PRODUCT MANAGER – become head of operations, with SA's leading start-up Dev agency. HYBRID. Centurion. R480K – R580K

    3 weeks ago

    Centurion, Gauteng, South Africa Acuity Consultants Full time

    Unique opportunity for an intermediate PRODUCT MANAGER to grow into a Head of Operations with leading start-up dev agency. This PRODUCT MANAGER opportunity is hybrid, in the Centurion area, and offers R480K – R580K p/a.

  • Intermediate PRODUCT MANAGER – become head of operations, with SA’s leading start-up Dev agency. HYBRID. Centurion. R480K – R580K.

    3 weeks ago

    Centurion, South Africa Acuity Consultants Full time

    Unique opportunity for an intermediate PRODUCT MANAGER to grow into a Head of Operations with leading start-up dev agency.  This PRODUCT MANAGER opportunity is hybrid, in the Centurion area, and offers R480K – R580K p/a.

  • Head of Technical Pricing

    6 days ago

    Centurion, South Africa K2 Human Capital Consultancy Full time

    **Job summary **- A Client in Centurion - Gauteng is looking for a Head of Technical Pricing to determine strategic direction for product development and pricing for the existing channels within the business and within the strategic context **Duties and Responsibilities** - Responsible for the technical pricing model development and implementation...

  • Head of Finance Operations | Centurion

    4 weeks ago

    centurion, South Africa Adzuna ZA B C2 Full time

    Our client is seeking a seasoned finance professional to lead operations at a prestigious financial services company. The successful candidate will be responsible for leading the sales credit risk, payroll/payments, commission & remuneration operational support and intermediary conduct teams within the client.Stakeholder Management:Build and maintain...

  • Head of Finance Operations | Centurion

    1 month ago

    Centurion, South Africa The Recruitment Council Full time

    Our client is seeking a seasoned finance professional to lead operations at a prestigious financial services company. The successful candidate will be responsible for leading the sales credit risk, payroll/payments, commission & remuneration operational support and intermediary conduct teams within the client.Stakeholder Management:Build and maintain...