Head of Operations, Claims and Internal

3 days ago

Johannesburg, South Africa PPS Recruitment Full time

**Job Advert Summary**:
To effectively lead, guide, and manage the Operational Call Centers as directed by PPS Short Term Insurance. The role involves driving and delivering exceptional performance through maximum effectiveness in claims processing, underwriting, administration, and internal distribution to our members. This includes ensuring cost-effectiveness, operational excellence, and enabling process innovation.

**Minimum Requirements**:
**Education**:

- NQF Level 5 - 120 credits Industry Relevant.
- A relevant bachelor’s degree.
- RE1 and RE5.

**Experience**:

- 15 years Short Term insurance experience of which ten years in a management role.
- 10 years Short Term insurance claims-specific experience of which five years must be in a management role (end-to-end validation and management of claims processes).
- Have a broader understanding of the regulatory environment in which the Organisation functions.

**Knowledge and Skills**:

- Extensive knowledge of Short-Term Insurance Claims.
- Extensive knowledge of Operations, processes and regulations
Extensive knowledge of distribution
- Experience in the development and enhancement of current business processes.
- Experience and knowledge of risk management and underwriting.
- MS Office package, particularly, Internet, Outlook and Excel.
- Excellent Knowledge of procurement systems like Codeplex

**Competencies**:

- Leading and Supervising.
- Ability to work under extreme pressure.
- Attention to detail.
- Strong communication skills (including report writing) and the ability to engage with various stakeholders throughout the business internally and as well as externally.
- Analysing data and extrapolating insights.
- Achieving Goals & Objectives.
- Adapting & Responding to Change.
- Adhering to Principles & Values
Special work

**Duties and Responsibilities**:

- Analyse and interpret all management information in the area (i.e. cancellation rates, loss ratios, claims paid, repudiations, conversion rates, turn-around times, mandates and sales) on an overall level and recommend corrective actions to the various managers (Claims Manager, Sales Managers and Servicing Managers) and underwriters.
- Effectively manage procurement and claims cost control.
- Make decisions w.r.t. complex claims, underwriting matters, sales decisions and servicing queries.
- Ensure the understanding and adherence to internal policies and procedures through ad-hoc audits and workshops and remain up to date with the changes in the industry to have the ability to share, test and implement best practices.
- Review and constantly monitor the work in progress (the number of claims reported as well as claims finalized, administration changes received to changes activated) in order to predict and implement capacity modelling.
- Engage with the relevant stakeholders, e.g. Head of Actuarial, External Distribution, Technical Operations Manager and others to define the quality standards in term of sales, claims, servicing and underwriting and implement best practices into the various areas of the call centers. Job Title Head of Operations, Claims and Internal Distribution (Short Term Insurance).
- Provide support throughout any changes in business processes and procedures through training, guiding and hands-on involvement to stakeholders such as the Claims Manager, Sales Managers and Servicing Managers.
- Ability to work accurately within tight deadlines and high workload whilst treating staff and clients fairly.
- Lead and manage a team of line managers by providing both technical and interpersonal guidance to achieve performance targets and ensure understanding by regular one on one discussions.
- Ensure agreed service level agreements with other stakeholders (e.g. Assessing, Loss Adjusting, Third Party and Recoveries) are adhered to ensure customer satisfaction and retention.
- Ensure measurement in place for management to drive and monitor client feedback within agreed turnaround times to ensure customer satisfaction exceeded in all Contact Centre areas.
- Work closely with the Technical Operations Manager on the performance and service delivery of external service providers (such as contractors and panel beaters).
- Ensure that the Operational Contact Centers internal relationships are maintained to provide good interdepartmental communication and mutual support by arranging and conducting interdepartmental meetings to resolve business issues and to discuss opportunities to change processes to be more aligned to the customer.
- Ensure the development of a high-performing team through embedding formal Performance Development processes and coaching.
- Establish and maintain a succession plan for the management team in the area using the formal Talent Management process for identified talent and an informal process for remaining roles.

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