Team Leader: Claims Management at AfroCentric Group

Job description

About the Role

To manage an operational team to ensure that Service Level Agreements and operational targets are achieved and exceeded by team in order to provide excellent customer service. Implement initiatives to improve overall service delivery and relationship building with both internal and external customers. Ensure all compliance requirements are implemented and upheld.

Who we are looking for

The candidate must be assertive, have a sense of urgency, must be able to deliver results and must be able to effectively lead others.

Skills

• Demonstrates Customer Focus
• Demonstrates Creativity
• Conflict Management
• Computer Technology Skills
• Communication Skills
• Business Writing Skills
• Attention to Accuracy and Detail
• Manage team and individual performance
• Numerical Ability
• Problem Solving
• Customer Focus

Experience

• 3-4 years hospital assessing/hospital administration.
• Experience preferably in ICU/Theatre Minimum of 2 years in a team leader/second in charge position in hospital assessing/hospital administration
• 3 years Private Hospital experience advantageous

Qualifications

Registered Nurse. Current SANC registration

What you will do

• Compliance and Risk Management:
• Analyse and provide client specific and business reports
• Defined legal, statutory and regulatory compliance is appropriately implemented and maintained at the required standards for the team
• Implemented team operational risk and governance structures, measures and frameworks are monitored and necessary action is taken to address issues, when necessary
• Financial Management:
• Manage expenses and costs and identify cost saving opportunities to support the department in achieving its financial goals and targets
• Operating Model:
• Ensure best quality work delivered by team in the execution of tasks
• Assist with implementation and maintenance of Standard Operations Procedures
• Investigate IT queries and escalate where required
• Implement team operational plans and manage that the defined delivery objectives are met through supporting, and being supported by other teams within and linked to the department / project
• Identify opportunities to improve the team's core operational internal processes and internal supply chain
• Resolve team operational conflicts
• Ensure delivery targets/objectives are met and motivate the team to operate in a mutually supportive manner to achieve successful delivery
• Operational Implementation of Strategy:
• Plan and implement daily, weekly and/or quarterly operational changes within the team to respond to important external influences
• Ensure relevant sections of the business plan are implemented in a manner that supports operational quality and meets the defined departmental priorities
• Communicate the relevant sections of the team operational plan to facilitate buy-in of the employees
• Ensure implementation of work plans in a way that maintains operational best practice and leads to continuous delivery improvement
• Operational Leadership:
• Manage the operational performance of the team as per HR frameworks and policies to ensure delivery to agreed standards and objectives
• Provide appropriate staff development, coaching and mentoring and retain skilled and engaged employees within the team and Medscheme
• Support transformation through valuing diversity within the team and department
• Behave in alignment with the Medscheme values
• Stakeholder Management:
• Ensure appropriate, active and informative relationships with customers and relevant stakeholders are successfully maintained
• Address customer or stakeholder complaints in alignment with the policies and procedures and ensuring customer / stakeholder buy-in