About Kaelo
Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change.
 

The Health Service and Claims Manager will establish the service centre and claims team objectives; provide consultants and team leaders with opportunities to expand their knowledge of services, products, and troubleshooting techniques. The Health Service and Claims Manager's primary objective is the efficient and effective running of the Health operational teams, motivating their team to maximise performance. They will need to analyse service centre and claims operational data and focus on improving performance and processes to better support customers. They serve our customers by planning and implementing operational strategies, improving systems and processes, and managing their staff.

KEY OUTCOMES

Reporting and Information Management

Ensuring data and information is maintained and accurate for the business unit and its functions

Ensuring that volumes and strategic objective targets are met for the assigned business functions

Maintain data and information relevant to service and operations for the purpose of conducting analyses that influence service specific decision making

Proficiency in financial analysis, being able to identify opportunities and the development of financially viable long-term service and operation plans

Weekly report management as specified

Client and Perception Management

Responsible for assessing, clarifying, and validating the client needs on an ongoing basis, maintaining high client satisfaction ratings that are up to the business’s standards

Best Practise and Continuous Improvement

Identifying opportunities by evaluating current business trends, best practise research and principles

Working closely with all business units to enhance and promote positive feedback loops and improvements

Works closely with all managers and teams coaching and mentoring the team’s development and professional skills

Strategy

Implement and lead business and campaign strategies that lead to high client, intermediary and team satisfaction

Management of the teams budgets, targets, performance objectives, standards and projects

Collaboration and Communication

Improve and drive cross-functional team collaboration through accurate and focused forms of communication

People and Team management

Ensure participative leadership and strong communication within the team

Collaborate with all business areas

Coach and manage peer to peer learning

Develop the team and ensure staff are well-trained the relevant technologies that they support/manage

Planning and Assessments

Determines service centre and claims operational strategies by conducting:

- Assessments

- Performance Review

- Capacity Planning

- Productivity Quality

- Customer service standards

Maintains and improves Health operations by monitoring system, people and process performance

Accomplishes people objectives by recruiting, selecting, training, assigning, couching, counselling and disciplining employees.

SPECIAL REQUIREMENTS

PERSON DETAILS: WORK EXPERIENCE

REQUIRED

3+ years in a managerial role

2+ years' service centre experience

Team management and leadership experience

PREFERRED

3+ years in an operations team managerial role

Health Insurance industry

Claims and/or Call centre experience

EDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED

Matric Certificate

RE5 Accreditation (a minimum of 120 credits)

PREFERRED

TECHNICAL SKILLS OR KNOWLEDGE

REQUIRED

Computer literate

PREFERRED

Proficient in MS Word, Excel and Powerpoint

Personal Attiributes 

• Accountability
• Action oriented
• Communication
• Simple writing skills
• Planning and organisation
• Resilient and adaptive
• Self-development
• Significance and values oriented