Health Business Owner at Kaelo Engage

Job Description

• The Health Business Owner will oversee our company’s operational processes and ensure superb customer experience. They will optimise our organisation's operating capabilities and employ strategies to maximize customer satisfaction.

DETAILS OF ROLE:

• Ensure the company’s strategies and operations align with their established plans and policies
• Work together with the senior executive team to develop and implement the corporate strategy
• Ensure optimal implementation and performance of certain essential functions
• Further develop and drive implementation of strategic objectives for the business and provide continuous thought-leadership
• Present new ideas, models and innovative solutions to strategic stakeholders and regularly report on progress
• Oversee daily operations and effectiveness of the business unit through the management team
• Ensures effectiveness within the service operating, workforce planning and quality models
• Provide leadership and guidance to direct reports across various levels within in the business unit
• Ensure overall delivery and quality of the unit's offerings to its stakeholders
• Generates annual budget, monitors, and approves expenses and reports on variances to superiors and the Finance department
• Assessing and implementing improved processes and new technologies and collaborating with management regarding the implementation of these improvements.

Daily and Monthly Responsibilities

• Oversee company operations and employee productivity, building a highly inclusive culture ensuring team members thrive and organisational outcomes are met.
• Driving the company’s operating capabilities to surpass customer satisfaction and retention, and company goals.
• Oversee daily operations of the company and the work of managers in membership, servicing, claims and billing functions.

These functions are responsible for:

Membership:

• Onboarding and Maintenance of Policy Holders, Clients, and Intermediaries
• Profile and policy management
• Maintenance of all stakeholder details
• Manage Offboarding of Clients and associated stakeholders
• Manage suspensions, resignations, and terminations
• Servicing and Executive Office:
• Ensure high quality query resolution while maintaining Service Level Agreements, Quality and Customer Perception Metrics
• Management of all complaints and ensuring customer experience metrics are achieved and maintained

Claims

• Ensure that claims are paid timeously and within Service Level Agreements
• Enhance and improve claims processes to ensure optimal client experience

Billing:

• Manage Billing Processes and Queries
• Prepare and Manage Billing Runs
• Manage Billing Reconciliations
• Manage Debt Outstanding
• Manage Intermediary Commissions
• Manage Premium Bordereaux
• Monitor performance with tracking and establish corrective measures as needed, and prepare detailed reports, both current and forecasting

Qualifications
WORK EXPERIENCE REQUIRED:

• At least 5 years of experience in relevant operations and preferably the healthcare industry
• 7-10 years’ experience in leading teams and major projects (senior management)

EDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED

• Relevant degree or equivalent qualification

PREFERRED

• Postgraduate or higher-level qualification

Additional Information
Personal Attributes 

• Accountability
• Action Orientated
• Collaborative 
• Communication Skills 
• Simple Writing Skills 
• Manages Complexity
• Problem Solving Skills 
• Creative Thinking
• Decision Making SKills 
• Efficient and Effective Mindset
• Financial Acumen
• Planning and Organisation 
• Resilient and adaptive 
• Resourcesful
• Signancance and values orientated