Health Product Manager at Kaelo Engage

Job Description

The Product Manager is responsible for the management and growth of the Network as well as product planning and execution throughout the Health and Schemes Product Lifecycles, including identifying potential products/updating existing products, defining the product vision, conducting market and customer research, generating product requirements and specifications as well as pricing by working closely with technology, project management office, sales, marketing and operations to ensure revenue and customer satisfaction goals are met. The Product Manager also ensures that the product supports the company’s overall strategy and goals.

KEY OUTCOMES - Health Product Management

The Product Manager is responsible the product vision, strategy and roadmap of the product ensuring the correct benefits and features are proposed and are in line with risk factors, cost, market, and customer expectations. Your role includes the co-ordination of teams to ensure the successful end-to-end delivery of product solutions.

The Product Manager also needs to ensure that the numerous Kaelo Health option benefits including that of Schemes, white label products and other Insurer products related documentation and delivery is as per the rules and policy documents.

Responsibilities: 

• Determining customer needs and desires by specifying the research needed to obtain market information.

• Create the product specifications for all new products incorporating customer needs and information provided in competitor analysis.

• Create/update the product content for all Health products as well as review and sign-off on all content and marketing material.

• Work with the actuarial team to determine pricing on products.

• Work with technology team, project management office and operations to ensure that the product is built into the systems as per the product specification and rules/policy documents.

• Work with other product owners to ensure integration of products and value-added services.

• Provide product knowledge to the Operational teams to ensure that the product is well understood for servicing.

• The ownership and management of the primary care benefit stack, ensuring that the benefits marketed and sold can be delivered efficiently via the administration system and network of providers

• Presentations to Board of Trustees for the schemes

• Scheme Road shows –Product pack for operational delivery to new and existing members

• Ensuring that the Service Level Agreements with clients are met and client expectations are managed

• Ensure retention of existing clients

• Identification and management of high-risk claiming members and providers ensuring rational, appropriate cost-effective health

Network Management

The Health Product Manager supports the business by ensuring that members have access to primary healthcare benefits via a stable multidisciplinary network of healthcare providers at an affordable and sustainable rate

Oversight of the following items which are implemented by the Networks team:

Onboarding - All providers contracted to Prime Cure must have signed a valid contract and completed the information sheet and provided Prime Cure with all required documentation, for example BHF registration, HPCSA certificate

Annual Fee negotiations with various providers including the Hospital networks, pharmacy groups, Laboratories, and other disciplines (contracted and non-contracted).

Driving the strategic objective of the company by ensuring network growth and stability, a happy educated provider who is a partner in the delivery of rational appropriate and cost-effective healthcare

Ensure Managed Care Accreditation

Co-ordination and management of provider profiling, peer review and intervention with outliers

Risk Analysis as a member of the risk forum, looking at:

• Demographics

• Geographic’s

• Individuals to groups

• Utilisation

• Identification of high-risk high claiming members

• Disease Burden

• Employer profile

Risk Management

The Product Manager supports and manages the design, implementation and evaluation of member management and GP utilisation programmes thereby ensuring that members receive, and providers provide rational appropriate cost-effective healthcare. The main objective of these programmes is to ensure that members lead a healthy, happy, and productive life

Scheme Management

• Client executive of Prime Cure clients including schemes

• Negotiation of contracts and fees

• Analysis of risk factors and potential solutions

Product Performance

• Analyses and reporting of:

• Utilisation

• Claims to capitation fee ratio

• Effect of managed care interventions

• Underwriting

Qualifications

SPECIAL REQUIREMENTS

Communication skills, Industry experience and knowledge

PERSON DETAILS: WORK EXPERIENCE REQUIRED

• At least 5 years’ experience in the healthcare Industry/ Insurance at a senior level

• At least 3 years’ experience in a product management role or

• 3 years project management/paralegal experience 

PREFERRED

• Ability to work under stress and tight deadlines

• Health Regulatory or Paralegal

• Knowledge of the Healthcare Industry

EDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED

• Project Management

• Business management

PREFERRED

• Health Regulatory or Paralegal

• MBA

TECHNICAL SKILLS OR KNOWLEDGE REQUIRED

• Microsoft 365 – specifically PowerPoint, Excel, and Word

• Project Management Tools – Microsoft Planner, Bitrix 24

PREFERRED

• Knowledge of the Healthcare Industry

• Enterprise Architect / Lucid Chart / Visio

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