Executive: Member Protection

3 weeks ago

Centurion, South Africa Letshalo HR Services Full time

**Key Responsibilities **include but not limited to the following:

- To lead and coordinate the development of the strategic plan, annual performance plan, and operational plans of the different Member Protection sub-divisions to ensure statutory reporting within set deadlines;
- To ensure alignment of strategy and budget allocations on an ongoing basis;
- To manage, monitor, and take accountability for performance of Complaints Adjudication, Customer Care, Clinical Consulting Services, and Education & Training;
- To act as a professional advisor to the Council on all relevant matters on an ongoing basis;
- To develop, review and recommend changes to policies and implementation procedures for the approval to the relevant stakeholders as appropriate on an ongoing basis;
- To manage sub-ordinates on an ongoing basis within key deadlines according to their KPAs and KPIs;
- To liaise with external stakeholders and to develop strategic relationships to inform the company's strategy on an ongoing basis within key deadlines;
- To build and maintain long term relationships with expert support panels to ensure improved quality of service to meet company objectives on an ongoing basis;
- To ensure the active engagement with stakeholders on issues affecting the medical schemes environment and our regulatory function through industry advisory committees on an ongoing basis;
- To ensure compliance with internal financial controls and the PFMA in the area under your control on an ongoing basis;
- To tie strategic objectives of the company to annual and medium-term budget proposals;
- Oversee and account for the management of audit activities effectively across Member Protection division;
- Oversee and account for the effective and efficient budget management activities within the division;
- Oversee and account for the management of effective and efficient risk management activities;
- To ensure daily optimum utilisation and improvement of the Human, Information and Organisational capital in your functional area to improve the Organisations utilisation of its Human, Information and Organisational resources; and
- To perform any additional responsibilities or tasks according to specifications as and when required.

**Minimum Qualifications, Experience and Knowledge**:

- Masters degree qualification in Public Health or Legal or Business Management;
- A minimum of 15 years overall experience, of which 5 years must be in a Senior Management role; 5 years in Complaints Management and 5 years in Private or Public health services;
- Sound knowledge of strategy and policy formulation;
- Knowledge of SAQA frameworks and Consumer Act/ Rights;
- SAs healthcare financing and delivery system, product knowledge and pricing;
- Knowledge of Medical Schemes Act and Healthcare environment;
- Knowledge of ethics and corporate governance;
- Knowledge of business risks and mitigation strategies
- Knowledge of all related legislation impacting and influencing the functioning of the organisation (MSA, PFMA, BBBEEA, LRA, EEA etc.);
- People management, financial and project management skills;
- Excellent communication skills, complaints resolution skills;
- Attention to detail, analytical skills, and ability to handle pressure;
- Ability to motivate and influence others; and
- Computer literacy.

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