Business Operations Specialist at Universal Healthcare

Why Join us?

Experience the Future of Healthcare Management and Technology!

At UniversalHealthcare, we revolutionize the industry with our cutting-edge solutions, serving over 40 healthcare funders in the public and private sectors. Join ourtrailblazing team and be part of a company committed to delivering superiorquality, fostering innovation, and achieving outstanding performance. Together, let's shape the future of integrated healthcare services

How You'll Contribute To The Team

As a Business Operations Specialist, you will be responsible for ensuring operational excellence by managing various aspects of business operations, including implementations, incidents, administration, quality control, and customer satisfaction. The role involves streamlining client implementations, resolving operational matters efficiently, and coordinating with stakeholders. It requires strong analytical, communication, and leadership skills, as well as proficiency in computer programs.

Implementations Management (Standard & Customised)

Manage Implementation, for specified Clients in terms of:
Source all information for implementations and ensure understanding of products - take responsibility for learning
Specifications o Enquiries relating to Implementations o Source information for SOL Implementation's or changes o Ensure monitoring of implementations are performed o Follow all processes related to Implementation Management

Incident Management

Manage Incidents in terms of:
Identify and log incident, once identified, and drive to closure in the shortest possible time Management of internal; or external impact of incidents with the relevant resources
Identify impacted areas or parties and inform or communicate to those required
Review and request closure providing a detailed root cause, resolution and continuous improvement
Attend incident meetings and provide feedback on the tickets as the resource o Follow all processes related to Incident Management

Administration Management

Produce accurate and quality Operations meeting agendas and minutes before and after monthly or quarterly Operations meetings.
Analysing and present the standard operational report pack for assigned funds on a monthly basis (on a quarterly basis for certain funds).
Review and understand the Business reports that are presented to funds on a monthly or quarterly basis.
Maintain a report schedule per fund on the shared access drive and ensure the schedule is updated monthly.
Compile and maintain the Contact Matrix per fund saved on the shared access drive.

Quality Control

Plan each implementation in terms of Project Management methodology.
Monitor SLA's agreed to in C1 contracts to ensure compliance.
Provide input for the continuous improvement and enhancement of the Implementation Forms and Process, including the checklists.
Identify areas for continuous improvement at MediKredit and/or funds by observing incidents, implementation, client complaints, comments, reports, call centre queries and other sources. Proactive issue resolution is required on a continuous basis.
Update and maintain allocated SOP's as per the review dates and identify interim changes to the SOP's and action accordingly.
Manage the entire operational process for specified funds including supporting areas for incidents, customised implementations and New Requirement Requests.
Build an Operational Base to operationalise the Funds in terms of support internally.
Ensure monitoring of implementations are performed as per SOP.
Review RMR and Back-end Rejections reports from the fund control department and report and implement rules/checks to reduce the high impact RMR's or rejections.
Train funds and 3rd parties on MK processes and systems.

Internal And External Customer Satisfaction

Schedule and chair Operational Meetings monthly with the assigned fund client. This serves as the primary client contact meeting to drive implementations.
Ensure that the fund client is kept abreast of legislation changes, product withdrawals, new products or MMAP categories changes to request changes to rules.
Attend Client Operations Operational Meeting and provide feedback or discuss requirements for implementations.
Consult with SQA (MK testing team) in terms of test cases and business requirements for all implementations that require testing.
Ensure all affected departments are up to date with the status of all actions for specified funds by providing feedback.
Ensure the Relationship Managers are kept abreast of all matters that impact on Customer Relationships.
Ensure that the Customer Care department understands new implementations in order to resolve provider/funder queries and to perform successful monitoring.
Attend Incident Meetings and provide feedback on all incidents at these meetings.

Minimum Requirements

Matric / Grade 12
Relevant Tertiary Qualification would be advantageous
At least 2 years post graduate experience in operations within a medical corporate environment
Clinical experience with Radiology and Pathology advantageous
Private Hospital billing advantageous
Scheme administration experience advantageous
Experience with analysing a business need, extracting the requirements into a functional specification
Customer interaction experience

Remuneration

A competitive salary and benefits will be negotiated, consistent with experience and the role andresponsibilities of the position.

The Employment Equity approach of Universal Healthcare broadly aims to foster diversity in the workplace; Promote equal opportunity and fair treatment in employment through the elimination of all forms of unfair discrimination.

Desired Skills

Implementation
Incident Management
Billing
Private hospital

Desired Qualification Level

Degree

About The Employer

About The Employer:

Universal Healthcarehas established itself as a leader in providing evidence-based, integrated healthcare services in the areas of medical scheme administration, healthcare insurance, healthcare management, corporate and occupational health and wellness, and integrated wellness-based loyalty programmes.

We create access to healthcare for the people of South Africa through medical schemes, customised corporate health products, health insurance, employee wellness programmes, managed care, a network of healthcare professionals, gap cover and much more.

Our Vision

"To be a topperforming, world class healthcare and technology group, respected forexcellence by providing access to innovative, evidence-based solutions with a caring approach."

Employer & JobBenefits