Job Vacancies at Health Solutions Africa

About the Job

Role Purpose

• Responsible for the design, development and implementation of operational reports at an Executive, Management and Client level in line with user and client requirements and in accordance with service level agreements, industry standards and best practice.
• To enable the generation of insights through multiple analytical and visualisation tools and techniques. This will include, but are not limited to Dashboards, Scorecards, Analytics and Data literacy programs.

Requirements

Qualifications

• Grade 12 or equivalent.
• Bachelor’s degree in Business, Finance, Information technology or related fields.
• Business Analysis (preferable)
• Project Management (preferable)

Experience

• 3 – 5 Years in a similar role
• 2 Years experience in Data analysis, Reporting or Business Intelligence
• Advanced proficiency in Microsoft Excel, SQL and PowerBI
• Leading Business/IT projects
• Experience in Medical Scheme or Financial Services environment (preferable)

Attributes

• Cross functional collaboration
• Communication skills (written and verbal)
• Problem solving skills (critical thinking)
• Facilitation and presentation skills
• Requirement articulation and documentation skills
• Ability to work in a pressurised environment & deal with multiple deliverables at once.
• Business acumen (operational knowledge & experience)
• Sense of urgency
• Enthusiastic, committed and proactive
• Methodical, analytical and accurate, with great attention to detail
• Business Report writing

Duties & Responsibilities

Internal Process

• Lead the design, development and implementation of Operational Reports, Scorecards and Dashboards for various stakeholders.
• Consult, analyse, standardize and automate the generation of reports as per SLA agreements and user requirements.
• Working with the BI team in developing performance measures, analyse drivers, trends and outliers as well as automating reports.
• Gather and interpret requirements from stakeholders in line with business analysis frameworks.
• Analyse and understand the business’ requirement and through a structured process document, validate and translate these into requirement specifications and functional specifications to be used by developers in crafting technical solutions and by testers to test and confirm successful delivery of solutions to the requirement.
• Contribute to translating the business goals into design in line with systems architecture.
• Act as a liaison between stakeholders and the project team to determine customer needs and translate these into business requirements.
• Oversee the quality delivery of requirements and specifications that meet the agreed deliverables in line with best practices and business process.
• Collaborate closely with solution teams and a variety of end-users to ensure requirements compatibility and end user satisfaction.
• Participate in the solution design process to make recommendations to create and enhance solutions that are innovative, repeatable and sustainable and solve complex business problems.
• Participate in User Acceptance testing and guide users to ensure that the designed solution ultimately meets business requirements.
• Define the success criteria using scenario testing and test cases to ensure that testing covers all aspects of the business specification.
• Test and validate the functionality of all technical solutions in line with business requirements on completion of development to ensure that business requirements are met in the implemented solutions.
• Define reporting requirements and integration points on affected components using diagrammatic representations.
• Collaborate with various business areas and teams to ensure integration and consistency of solutions across business.
• Develop and implement a Data Literacy program across Operations that will enable data driven decision making at all levels.

Client

• Provide authoritative expertise and advice to clients and stakeholders.
• Build and maintain relationships with clients and internal and external stakeholders.
• 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 the area of responsibility.
• Participate and contribute to a culture that builds rewarding relationships, facilitates feedback, and provides exceptional client service.

People

• Develop and maintain productive and collaborative working relationships with peers and stakeholders.
• Positively influence and participate in change initiatives.
• Continuously develop own expertise in terms of professional, industry and legislation knowledge.
• Contribute to continuous innovation through the development, sharing and implementation of new ideas.
• Take ownership for driving career development.
• Monitor on an ongoing basis the training and development needs of employees within this portfolio.
• Create a positive work climate.
• Provide guidance, coaching, and mentoring to direct reports.
• Lead by example in living the values of the organisation and aligning with the values of the client.
• Demonstrate exemplary leadership.
• Participate in the recruitment of staff in accordance with Momentum Metropolitan EE Targets.
• Provide transformation interventions on areas that require immediate attention in order to create harmonisation and thereby accelerate performance.

Finance

• Identify opportunities to enhance cost-effectiveness and increase operational efficiency.
• Manage financial and other company resources under your control with due respect.
• Provide input into the risk identification processes and communicate recommendations in the appropriate forum.

Competencies

• Business acumen (operational knowledge & experience)
• Client Commitment
• Drive for results
• Leads change and innovation
• Collaboration
• Impact and Influence
• Self-awareness and insight
• Diversity and Inclusiveness

go to method of application »

About the Job

Role Purpose

• To liaise between Momentum Health Solutions and MDS to ensure there is a good working relationship at all levels.

Requirements

• Matric/ Grade 12
• Relevant Qualification (Added Advantage)
• 5 Year's experience in the Health Industry
• Sales experience

Duties & Responsibilities

• Liaise between Momentum Health Solutions and MDS to ensure there is a good working relationship at all levels
• Attend MDS Exco on a monthly basis
• Position and help steer the health strategy within MDS
• Meet with the various stakeholders within MDS to ensure alignment between MHS and MDS
• Discuss and drive relevant activities towards achieving the set health targets with all MDS regions on a regular basis
• Ensure health targets are met and help to set new targets each year
• Co-ordinate regular service meetings between relevant areas
• Support and manage the MDS BDMs
• Facilitate Thought Management sessions for selected advisors quarterly
• Manage the Health Master Classes and other training requirements
• Meet with Key MDS advisors
• Keep MDS informed of relevant product house changes
• Keep MDS informed of relevant health industry changes
• Manage new segmentation model and relevant incentives for MDS

Competencies

• Providing Insight
• Developing Strategies
• Decision Making
• Generating Ideas
• Empowering Individuals
• Exploring Possibilities
• Directing People
• High level strategic thinking

go to method of application »

About the Job

Role Purpose

• The Clinical Risk Manager will act as a trusted advisor, collaborating with clients to improve health outcomes, reduce risk and ensure that services align with business priorities and client needs.

Requirements

• National Senior Certificate
• The incumbent must have a degree in the field of health (e.g. B.Pharm, BCur)
• A postgraduate leadership qualification would be highly advantageous
• Must be registered with the relevant regulatory body determined by the qualification
• 5 Years' working experience in a managed care environment in a senior operational, managerial or strategic role
• 2 Years' experience in a client facing role
• Knowledge of healthcare industry legislation, trends and competitors
• Knowledge of healthcare management and managed care practices
• Understanding of medical scheme industry rules, regulations and benefit structures
• Must be in possession of a valid driver's licence and own insured vehicle

Duties & Responsibilities
Process

• Foster a strong innovation focus within our Health Risk Management offering to drive continuous improvement and stay ahead in the industry.
• Provide meaningful and relevant appropriate reporting on Health Risk Management functions and trends to enable informed decision-making and proactive risk management.
• Ensure accurate reporting on all strategic, operational and contractual requirements to maintain transparency and accountability.
• Act as the custodian of the Health Risk Management escalation matrix to facilitate efficient issue resolution and escalation processes.
• Inspire collaboration within the Health Risk Management Team and wider business unit to foster a culture of teamwork and knowledge-sharing.
• Assist and support the Head of Operations and Head of HRM strategy in meeting the business needs of clients by aligning strategies and actions accordingly.
• Facilitate the proficient implementation of the Health Risk Management and products strategy to drive successful outcomes.
• Oversee the Managed Care admin interface to ensure the successful application of program specifications throughout the value chain.
• Take accountability for all audit and risk management requirements, ensuring compliance and minimising risk exposure.
• Provide clinical input and assistance as needed in the business to ensure quality and effectiveness.
• Facilitate the adoption of various forms of technology to drive the achievement of beneficiary wellbeing and good clinical outcomes.

Client

• Continuously monitor turnaround times and quality standards, resolving issues promptly to enhance client service delivery and satisfaction.
• Drive the achievement of client service delivery goals in line with predefined standards, ensuring clients receive appropriate advice and exceptional after-sales service.
• Manage client query processes, accurately track and resolve queries, and utilize them as a mechanism to improve client service and streamline business processes.
• Provide risk management expertise and advice to clients and stakeholders, ensuring effective risk mitigation and compliance.
• Build and maintain strong relationships with clients and internal and external stakeholders to foster collaboration and mutual success.
• Contribute to the process of negotiating objective and realistic service level agreements, monitor their appropriateness and recommend adjustments to enhance client satisfaction.
• Make recommendations to improve client services and promote fair treatment of clients within the area of responsibility, ensuring high levels of client satisfaction.
• Actively participate and contribute to a culture that builds rewarding relationships, facilitates feedback and consistently delivers exceptional client service.

People

• Create a positive work climate and culture to energise employees, give meaning to their work, minimise work disruption and maximise employee productivity.
• Demonstrate exemplary leadership behaviour through personal involvement, commitment and dedication in support of organisational values.
• Drive a culture that guides and directs best practices, fostering an environment of continuous learning, improvement and cohesiveness.
• Enable a learning and growth culture where information regarding successes, issues, trends and ideas is actively shared between team members, promoting collaboration and innovation.

Financa

• Implement and manage financial risk methodologies, techniques and systems to effectively 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 organisational policy and practice and report on findings to ensure adherence to compliance standards.

Competencies

• Collaboration
• Business acumen skills
• Client relation skills
• Change management skills
• Innovation skills
• Report writing skills
• Strategic thinking
• Influencing skills
• Customer relationship management
• Strategy translation skills

go to method of application »

About the Job

Role Purpose

• To ensure that administrative functions within the Employee Assistance Programme Care Center are completed within SLA resulting in cases being managed efficiently.

Requirements

• National Senior Certificate
• Successfully completed social auxiliary work training
• Registration with the South African Council for Social Service Professions (SACSSP) as an Auxiliary Social Worker
• A minimum of two years of experience, after registration with the SACSSP
• Experience of working full-time within a call center would be an advantage
• Sound knowledge of the Microsoft suite

Duties & Responsibilities

• Providing support to the case managers, including but not limited to liaising with various stakeholders and ensuring that clients adhere to follow-up sessions and client check-ins.
• Liaising with affiliates for updates on referred cases.
• Ensure fair distribution of work that comes into the allocation inboxes.
• Keep accurate records for each piece of work done, including appointments, phone calls, referrals, action plans/revisions and any other significant information affecting the tracking of a client’s interaction with the Team.
• To accurately capture and process affiliate invoices within the required timeframes.
• Responding to after hours and weekend crisis calls for assistance when necessary.

Competencies

• Ability to maintain composure under pressure and deliver on deadlines, while remaining client centric at all times
• Agile and flexible around challenges, whilst maintaining good communication with all relevant stakeholders
• Excellent communication skills
• Ability to be resourceful and innovative through collaboration, creativity and drive
• Attention to detail and high levels of accuracy
• A sincere interest in the well being in the well being of people
• A strong sense of responsibility
• Ability to work in a diverse team

go to method of application »

About the Job

Role Purpose

• Deliver professional service to clients through various servicing channels, responding to their needs, concerns and complaints within agreed Service Level Agreements and legislative and compliance requirements.

Requirements

• Matric or an equivalent qualification
• 1 - 2 years experience in a callcenter or client service environment (essential)
• Experience in medical aid administrative and/or healthcare experience (essential)
• Excellent telephony and verbal communication skills
• Excellent typing skills and proficiency in MS Office

Duties & Responsibilities

• First call resolution for resolving member and service provider queries.
• Flexibility to be able to handle telephonic and/or written inquiries.
• Ensuring the Scheme and in particular, Momentum Metropolitan Holdings Health is not unnecessarily exposed to financial risk asa result of incorrect information being provided to members and service providers.
• Ensuring quality service,production, first call resolution and appropriate follow-up to ensure resolution of queries
• which deliver effective individual contribution towards service level agreement compliance.
• Client retention and goodwill by effectively resolving queries from members, employer groups,service providers and the Scheme.
• Understanding and effectively using the call center telephony system and workflow management system.

Competencies

• Ability to learn and apply new skills
• Team Orientation and attention to detail
• Flair for decision-making and problem solving
• Customer service orientated
• Initiating action (taking promptaction to accomplish objectives)
• Good listening skills
• Good telephone ettiquette
• Calm under pressure
• Ability to work in a structured environment