- Responsible to ensure that all claims operations adhere to days claims processing requirements in line with the organization mandate.
- Bachelor’s Degree in a Business Management or Administration related qualification.
- Post graduate Business Management or Administration related qualification.
- At least 12-15 years’ relevant experience of which 7 (seven) years must have been at a general/senior management level.
- Advanced knowledge in claims management systems, insurance/reinsurance principles and Motor Vehicle Accident legislation will be advantageous.
- Experience in leading and managing organisational transformation will be an added advantage
- Advanced knowledge of claims management process/ processes and systems.
- Understanding of claims medical management.
- Understanding of the claims mediation and litigation model.
- Complex problem identification, solving and decision making.
- Network and alliances
- Talent management.
- Knowledge of Motor Vehicle Accident legislation.
- PFMA knowledge.
- Knowledge of budgeting, sales, business development, and strategic planning.
- Strategic capability and leadership.
- Results orientation.
- Business and financial acumen.
- Brand and stakeholder orientation.
- Change management.
- Treasury regulations.
- Customer value proposition.
- Good financial management skills.
- Strong Analytical capabilities.
Key Performance Areas:
- Lead the development of functional reporting systems, for management, project or performance reporting.
- Provide oversight to the development of reports/ policies/ procedures and guide the process through the alignment of these documents to the overall organization’s Strategy.
- Oversee medical supply agreements, implement cost analysis strategies and negotiate with suppliers accordingly.
- Maintain relationships with the different claims counterparts to flag problems and risks, and proactively shape any regulatory guidance.
- Oversee the management of daily operations and functions for all claims processes within the Organization.
- Ensure that the claims received are assessed in accordance and aligned to merits thereof.
- Oversee the management of the full lifecycle of a claim process, including claims origination, receipt, validity and verification checks, merit
- assessments, quantum assessment, litigation, settling, payment, finalising and archiving of a claim, as well as the post-crash settlement care.
- Develop KPIs for new products, including measurement frameworks and data feedback strategies.
Ensure quality control of all claims process outputs as it pertains to customer satisfaction and...