Manager: Claims

2 weeks ago

Cape Town, South Africa Momentum Metropolitan Holdings Full time

-Introduction
Role Purpose

To oversee and take accountability for key Claims functions and as a result ensure that MHC continues to efficiently and effectively provide leading administrative services to the Scheme and its members. Further to this, ensure standardisation, consistency and optimisation of processes across claims administration.
Requirements
- Matric or equivalent qualification essential
- A Degree ideally in the areas of Business administration or clinical in nature advantageous
- Minimum 2 - 5 years management level experience within a major healthcare organisation, health system setting or large multi-operational corporate environment in complex industries similar to healthcare essential
- Experience managing a budget. Strong financial and business acumen, knowledge of budgeting and forecasting methodologies advantageous
- Proven track record of driving successful performance outcomes and accomplishing organisational goals essential
- Experience anticipating and responding to the needs of internal and external customers.
- Must have managed large scale claims divisions (preference will be given to those with experience in a medical aid or managed care environment) essential
Duties & Responsibilities
- Strategically develop the roadmap in making the Claims division a Centre of Excellence in the healthcare environment
- Ensure that the departmental successes are in line with the MHS Strategic and Operational plans
- Ensure that the BU objectives and successes are aligned to the MHS (client) Strategic and Operational plans
- Facilitate effective and efficient business systems and processes in a growing environment
- Effective and efficient stakeholder/client management
- Effective and efficient communication to all clients
- Business Process enhancements, creating efficiencies at a Qualitative and Quantitative level
- Effective and efficient quality assurance measures
- Ensure continuous innovation happens at all levels in the organisation, to enable an efficient and accurate claims environment
- Ensure all claims processes are at the desired levels of quality to mitigate risks and meeting SLA's
- Consistent and frequent communication and feedback to employees
- Clear Communication on Ethics Awareness strategies
- Execution of Personal Development Plans
- Clear succession planning document detailing all identified successors for critical positions
- Employee development through critical projects
- People Management and Development
- Budget reporting and adhoc reporting
Competencies
- Strong Finance and Operations Management background
- Must have managed large scale divisions
- Ability to engage at an Executive level
- People management skills (interpersonal skills, communication skills, assertiveness, adaptability, negotiation skills, conflict handling, listening skills, mentoring)
- Creativity and innovation - taking advantage of opportunities and solving problems
- Excellent Communication Skills (verbal and written)
- Analytical thinking
- Relationship building
- Workforce management
- Accountability
- Organisation and attention to detail
- People skills
- Customer orientation
- Communicating with impact
- Decision making and problem solving
- Enable team successes
- Results orientation
- Ability to influence

Policy

We are committed to Employment Equity, diversity and inclusion when recruiting internally and externally. All appointments are made in alignment to our Employment Equity goals and we encourage people with disabilities to apply.

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