Claims Manager

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.

We help people grow their savings, protect what matters to them, and invest in the future. We help companies and organizations care for and reward their employees and members. Through our own network of advisers or via independent brokers and utilising new platforms Momentum Metropolitan provides practical financial solutions for people, communities, and businesses.

Introduction

Momentum Health Solutions (MHS), an entity of the Momentum Metropolitan Group (MMG), 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

To oversee and take accountability for key Claims functions and as a result ensure that MHS continues to efficiently and effectively provide leading administrative services to the Scheme and its members. Further to this, ensure standardization, consistency, and optimization of processes across claims administration.

What you’re going to do

  • 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
  • Understand and apply principles of best practice in business process analysis
  • Understand and apply quality standards and assurance
  • 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

What you’ll need:

  • Matric or equivalent qualification
  • Degree required ideally in the areas of Business administration or clinical in nature
  • A post-graduate degree or MBA will be advantageous
  • Minimum 5 years of progressively responsible managerial experience in designated facility, business entity or area.
  • Minimum 2 years management level experience within a major healthcare organization, health system setting, or large multi-operational corporate environment in complex industries similar to healthcare
  • Experience managing a budget.
  • Strong financial and business acumen, knowledge of budgeting and forecasting methodologies.
  • Proven track record of driving successful performance outcomes and accomplishing organizational goals.
  • Experience anticipating and responding to the needs of internal and external customers.
  • A strong Finance and Operational management background
  • Must have managed large scale claims divisions (preference will be given to those with experience in a medical aid or managed care environment)

What competencies you’ll require

  • 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
  • Business acumen – an understanding and application of business principles and processes to enhance profitability
  • 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

We reserve the right not to fill this vacancy

Location

Cornubia, Durban

How to apply

 Click here to Apply.

Leave a Reply

Your email address will not be published. Required fields are marked *