Implementing the HRM strategy as part of a client centric service offering.
Requirements
- Matric or equivalent
- Bachelors Degree would be an advantage
- Attended a MMI accredited Leadership course would be an advantage
- A good understanding of the healthcare industry i.e. trends, competitors and legislation.
- 3 5 years management experience in a clinical and service environment is essential.
- Previous experience or knowledge of the financial services, insurance and health care industry would be advantageous.
- Implementing the Health Risk Management strategy as part of a client centric service offering.
- To ensure a strong innovation focus within our Health Risk Management offering.
- Meet and exceed all SLAs.
- Forecasting, budget control and resource planning.
- Provide meaningful and relevant appropriate reporting on Health Risk Management functions and trends as required
- Ensure that all strategic, operational and contractual obligations are met and also accurately reported on.
- Being the custodian of the Health Risk Management escalation matrix
- Maintain and develop relationships with key internal and external stakeholders.
- Maintaining great staff morale
- Developing highly motivated and dedicated teams.
- Ensuring adequate training and development of all staff
- Instilling a performance driven culture
- Inspiring collaboration within the Health Risk Management team and wider business unit.
- Assisting and supporting the Head of Operations and Head of HRM strategy to meet business needs of clients.
- Operational management of the wellness coach, case management and disease risk management team collectively known as the Health Risk Management team.
- Facilitate and supervise the proficient implementation of the health risk management and products strategy
- Responsible for managing the Managed care Admin interface to ensure successful application of programme specification through the value chain
- Maintain professional communication between MMSA and members, providers, schemes and other healthcare professionals within the context of MMSAs risk management process
- Develop, maintain and update business processes for HRM service delivery in line with product design and customer-specific segment requirements
- Take accountability for all audit and risk management requirements as required
- Provide clinical input and assistance where required in the business.
- Insight into and an understanding of the importance of industry issues and its implication on the operational areas and incorporating required changes.
- Provide support to segments and channels on operational queries and escalations
- Continuously monitor turnaround times and quality standards and resolve issues speedily to enhance client service delivery
- Drive client service delivery goal achievement in line with predefined standards in order to ensure that clients receive appropriate advice and after sales service.
- Manage client query processes and ensure that queries are tracked, accurately resolved and used as a mechanism to improve client service and business processes
- Provide regular reports on delivery of services against agreed service level agreements and in terms of overall client targets.
- Provide authoritative, expertise and advice to clients and stakeholders
- Build and maintain relationships with clients and internal and external stakeholders
- Contribute to the process of negotiating objective and realistic service level agreements, monitor appropriateness and recommend adjustments
- Deliver on service level agreements made with clients and internal and external stakeholders in order to ensure that client expectations are managed
- Make recommendations to improve client service and fair treatment of clients within area of responsibility.
- Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service.
- Create a positive work climate and culture to energise employees, give meaning to work, minimise work disruption and maximise employee productivity.
- Demonstrate exemplary leadership behaviour, through personal involvement, commitment and dedication in support of organisational values.
- Select and recruit suitably qualified talent in line with Employment Equity principles and MMI values
- Drive a culture that guides and directs best practice, fostering an environment of continuous learning, improvement and cohesiveness.
- Enable a learning and growth culture whereby information regarding successes, issues, trends and ideas are actively shared between team members.
- Execute effective workforce planning practices to ensure that staffing requirements are accurately forecasted
- Identify employee growth and development needs and schedule interventions to enable ongoing development, training and personal growth.
- Effectively manage performance within the team in order to ensure business objectives are achieved
- Encourage innovation, change agility and collaboration within the team.
- Control the budget for area, including the authorisation of expenditures and implementation of financial regulations.
- Manage high risk and problematic financial issues in area of accountability and contribute to the development of policy.
- Plan and implement a cycle of medium term improvements to drive pricing of services and products.
- Implement and manage financial risk methodologies, techniques and systems and use to monitor and report on financial activities.
- Implement and provide feedback on the effectiveness of financial policy, practice and procedures: preventing illegal, unethical or improper conduct.
- Implement risk management, governance and compliance policies in own practice area, to identify and manage governance and risk exposure liability.
- Investigate reported wilful acts of non-compliance to organisation policy and practice and report on findings.
- Support with effective and efficient managing of operational costs to remain within budget including payment models PFP
