Scheme Executive

-Introduction

Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by using a defined set of Health capabilities.
Role Purpose

Build and maintain relationships with clients and stakeholders to deliver on the Client Value Proposition and achieve the business unit's overall strategy. Accountable for managing respective client portfolio delivery as per contracted service schedules.
Requirements

**Qualifications**
- Matric or equivalent
- Relevant business qualification
- A clinical qualification would be an advantage

**Experience**
- Minimum of 8 years relevant industry experience
- Minimum of 2 years client engagement experience
- Sound knowledge of the Medical Schemes Act and Regulations

**Attributes**
- Ability to work under pressure and adapt to a changing environment
- Ability to solve complex problems
- Ability to coordinate execution and delivery with a strong focus on client satisfaction
- Ability to build and maintain strong relationships
- Ability to interact and communicate with all stakeholders
Duties & Responsibilities

**Internal Processes**
- Represent/ support all areas of business at client engagements, coordinating delivery from affected products and channels.
- Represent the interests of clients and report customer viewpoint to business, keeping business informed of client developments, demands, concerns and agreed deliverables
- Maintain oversight of execution on administration, managed care and deliverables as per agreed terms in collaboration with the appropriate segments, distribution channels and product houses.
- Drive the delivery of the Business Unit objectives in different capabilities and forums, driving alignment of service offering and customer experience with client needs & expectations
- Execution and management of all client communication requirements.
- Drive and facilitate the efficient and effective delivery of annual and ad hoc client projects.
- Maintain up-to-date knowledge of Momentum Health's solutions and products, and identify areas for cross
- and up-selling
- Manage quality & quantity of all client interactions and establish, maintain and enhance client satisfaction measurement.
- Manage a client service excellence culture that builds enduring relationships and allows the team to provide exceptional client service.
- Execution on day to day business requirements of client as per CMS requirements (rule submissions, AGM and other statutory requirements).

**Client Focused Delivery to Enable Strategic Client Engagement**
- Keep abreast of industry changes as it impacts business and client.
- Review, update & manage the execution of strategies to optimize retention opportunities
- Coordinate & contribute to reporting and feedback process in order to demonstrate MMI induced value
- Contribute to scheme design process by providing input and insights both from a client and business perspective.
- Build and maintain relationships with clients and stakeholders that promote cross-delivery practice solutions and make recommendations to align service offerings with client needs.
- Manage a client service excellence culture that builds enduring relationships and allows the team to provide exceptional client service.

**Contribution Towards the Implementation of Financial and Corporate Governance Measures**
- Assist in driving profitability by optimizing costs and reducing inefficiencies for the benefit of both the client and the business.
- Manage the impact of back-office support and resource allocation to ensure costs are managed according to work demand
- Review and update proposed strategies and manage execution to ensure client retention and optimise revenue opportunities
- Drive, monitor and contribute to adherence to operational, governance and compliance processes to mitigate business risk
- actively contribute to internal and external audit reviews
- Manage governance and compliance through keeping abreast of regulatory environment as well as scheme SLA's and rule changes.
Competencies
- Business Acumen
- Stakeholder engagement and management
- Drive for results
- Collaboration
- Leads change and innovation
- Impact and 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.