Job Vacancies at Rand Mutual - RMA

Purpose

Reporting in to the RMA: Head of Corporate Actuarial, the incumbent will be responsible for overseeing the development and maintenance of the actuarial valuation system and ensuring ongoing data; ensuring that all actuarial valuations are prepared timeously and accurately. An integral part of the role will also be supporting business with insights and producing reports for the executive and various committees.

Qualifications and Experience required

• NQF Level 7: Bachelor’s degree – Actuarial Science
• Progress towards actuarial exams – preferably Associate actuary, but consideration would be given to strong candidates with less exams
• Minimum 5 years’ experience in the non-life insurance environment
• Team leadership experience

Key Areas of responsibility

Valuations and reporting:

Ensure accurate and timely preparation of the actuarial valuation for the life and non-life businesses including:

• Data preparation and checking
• Reserving
• Embedded value
• Solvency
• Production and monitoring of various key performance indicators
• Providing insights to business
• Assist and provide input into the budget process
• Ensure actuarial components of regulatory submission (ORSA and SAM) are completed
• Support the business with capital management
• Prepare and present actuarial matters to exco and the Board and act as an advisor to the Board and its sub-committees
• Experience investigations and assumption setting

Staff management:

• Manage, supervise and training of staff
• Manage relationships within the company and stakeholders e.g. Statutory Actuary
• Lead and motivate the team to achieve targets

Development:

• Implement IFRS17 across the business
• Build and maintain actuarial models
• Maintain model governance

Ad-hoc:

• Assist with ad-hoc projects
• Assist and provide input on pricing and product development

Knowledge, Skills and Competencies required

• Knowledge of business policies, processes and procedures, legal compliance
• Reporting experience
• Valuation experience
• Life and non-life experience
• Knowledge of the Insurance Acts (long and short term) including SAM, IFRS17
• Actuarial guidelines
• Experience leading/managing a team
• Attention to detail
• Knowledge/Information Management
• Financial acumen
• Interpersonal awareness / empathy
• Judgement and Decision-making
• Analytical thinking

go to method of application »

Purpose

Reporting to the General Manager: Information Communications and Technology, the incumbent will be responsible for ensuring that IT application systems are developed, enhanced, maintained and available at the agreed quality, efficiency, effectiveness and service levels to enable business to fulfil their processing and information storage requirements and enable RMA to licence their system to other entities.

The incumbent will also be responsible for managing a team of Business and Systems Analysts, Testers, Developers and Architects to ensure the successful implementation of systems that meet the needs of the business

Qualifications and Experience required:

• NQF Level 7: Bachelor’s Degree in IT or related field
• At least 7 years’ experience of which 5 must be in managerial position

Key areas of responsibility

Management of ICT applications systems development, enhancement and maintenance

• Manage the relationship with business in a way that understands, anticipates and manages the business application systems requirements and needs
• Manage and perform the gathering, analysing and documenting of business requirements
• Manage the Technical and Solutions architecture
• Manage systems analysis
• Manage and perform the development, enhancement and support of application systems
• Manage projects relating to the improvement of application systems services
• Prioritise system development, maintenance and enhancements with Business and ICT Developers
• Manage and perform application systems testing
• Plan, allocate, organize and control ICT application systems tasks and projects
• Ensure that quality and satisfaction levels with ICT application systems remains high
• Manage systems recovery for business continuity
• Manage breaches of application systems and information
• Ensure systems development and enhancements are comprehensively documented
• Ensure the securing of the application system sources code and stored procedures
• Ensure that application development framework, coding standards, development methodologies, procedures and documentation are always adhered to
• Provide ongoing advice and support to business on innovative technologies and their platforms to drive efficiencies

Management of policies, procedures and compliance

• Establish policies to manage systems development, enhancement and maintenance
• Develop and implement application system development policy, including business analysis and testing policies and procedures
• Define, set-up and manage SLA’s
• Conduct regular audits on the use of ITIL, Cobit and best practises methodologies
• Responsible for managing the adherence of the Quality Assurance processes and approvals thereof
• Ensure development teams adhere to architectural principles and standards at all times
• Provide ongoing feedback and guidance to business on system and data compliance against FSC standards and COID Act
• Represent ICT by actively participating in various forums (Opsco, Pricing committee, IT SteerCo, Exco Prioritisation Committee, Architect Committee, Workplace Forum, Manco

Day-to-day team management

• Manage the day-to-day running of the application development and support teams (developers, business analyst, systems analyst, testers) by providing management (performance management, day to day management, employee relations, annual leave, sick leave, scheduling etc.)
• Actively participate in the recruitment process (i.e. interviews and decisions on candidates etc.)
• Provide technical support to the ICT application development on a day-to-day and on an ongoing basis
• Define, set-up and manage individual KPA’s
• Provide of guidance to technical staff in the creation of work processes and procedure writing
• Ensure that the team delivers according to project / strategic timelines

Knowledge skills and competencies required:

• Thorough understanding of business analysis methodologies and processes
• Thorough understanding of system analysis methodologies and processes
• Thorough understanding of Application systems development methodologies and processes
• Thorough understanding of testing methodologies and processes (auto/regression, manual)
• Thorough understanding of systems requirements gathering, analysis, development and testing technologies and processes
• Understanding of the insurance environment and COIDA
• Understanding of Agile/PM methodologies
• Knowledge of business policies, processes and procedures, legal compliance
• Service Orientation / Customer Responsiveness
• Leading and supervising
• Planning, Organising and Follow through
• Program and Project Management
• Complex problem-solving
• Technology and innovation

go to method of application »

Purpose of the role

Reporting into the General Manager: Claims and Medical Management the incumbent will be accountable for the implementation of the medical occupational management framework for compensation benefit processing and will be responsible for making strategic decisions concerning the adjudication, assessment, and liability of the Medical Management department.

Qualifications and experience required:

• Medical Degree (MBChB)
• NQF Level 9: Master’s Degree in an Accredited Healthcare or Insurance Qualification -
• Master of Business Administration preferably in Health Care Leadership or Postgraduate Medical Management Qualification (preferred)
• Occupational Health qualification diploma /degree (DOH)
• At least 10 years of relevant clinical experience
• At least 5 years of managerial experience in the healthcare insurance, occupational health, and/or compensation environment
• Registration with a recognised Healthcare Provider Association

Key Areas of Responsibility:

• Organising, coordinating, and supervising the department towards greater functional efficiency and ensure the continuous improvement of policies and strategic direction in line with best practice
• Develop, establish, and manage key support networks and provide the medical support to stakeholders.
• Manage projects and programs and ensure the provision of medical advice and training to all stakeholders of Rand Mutual Assurance.
• Effective medical management
• Assume overall accountability for the medical authorisation and management of all claims and ensure medical support for claims management with respect to complex medical matters
• Provide medico-legal advice to operational processes so that disputes, repudiations, hearings, backlogs, and medical liability can be determined
• Guide investigations with respect to the acceptance of liability for high cost or complex medical accounts
• Provide technical advice and feedback on trends regarding treatment
• Maintain and continuously review medical claims policies and procedures
• Oversee the function’s daily operations and procedures as well as the overall efficiency of the Medical Department
• Ensure that there are processes, procedures, and systems to facilitate effective and efficient medical claims adjudication and management, and adherence by using effective measurement tools
• Issue new directives and changed procedures to update medical operational and process efficiencies and controls in line with best practice
• Ensure accurate reporting on all departmental objectives and outcomes
• Cost Management
• Prepare and manage departmental budget
• Analyse medical spend and provider usage patterns
• Work with other executives on budgeting, forecasting, and resource allocation
• Manage medical provider service delivery to ensure quality and sustainable medical services at an affordable cost
• Ensure proper accounting records are maintained
• Oversee the correct cost evaluation of clinical elements for the processing of claims
• Monitor actual performance against budgets, forecasts, and projects
• Identify high risk, high-cost pensioners to assist proactively
• Ensure treatment plans fit individual needs
• Promote cost-effective health care regionally
• Motivate adherence to the National Health Reference Price List (NHRPL) rates for subsequent care
• Motivate for alternative reimbursement models
• Regulatory compliance and risk management
• Ensure legislative compliance and compliance in all matters relating to medical claims, compensation, and treatment requirement
• Ensure proper reporting to the Compensation Fund and other relevant entities for purposes of regulatory compliance
• Ensure adherence to all relevant people management legislation, procedures, and policies
• Ensure compliance and the management of risk actions for the department
• Develop and implement a return to work programme for claims
• Develop a Health and Safety programme in collaboration with employees
• Customer and stakeholder engagement and liaison
• Ensure regular liaison and effective communication with HCP and provider network, sharing RMA requirements and preferences
• Represent the Medical Department at internal & external meetings when required
• Oversee the assessment of clinics in various regions upon instructions of the Compensation Commissioner
• Engage and maintain effective communication with internal and external stakeholders: both administrative and medical colleagues to enhance understanding of medical treatment options, benefits, and procedures
• Provide feedback to colleagues on medical issues where appropriate
• Effective leadership and development of the Medical Management team
• Oversee and support all units within the medical management department
• Ensure departmental leadership and alignment to the company’s strategic vision, values, and business plan
• Evaluate the performance of direct reports against contracted performance targets, identify performance and developmental gaps and agree on personal development plans
• Promote a spirit of equality and non-discrimination and ensure that policies are implemented fairly and consistently
• Develop and maintain a work environment that recruits retains, and supports high performing employees
• Participate, and encourage subordinates to participate, in seminars, workshops, and conferences and online learning as identified in personal development plans
• Keep abreast of emerging trends in health care delivery; identify and define new and innovative strategies to achieve organisational goals and objectives
• Grow and maintain a strong medical community of practice and cultivate a learning culture amongst medical and administrative colleagues

Knowledge, Skills and Competencies required:

• Proficiency in Microsoft office 
• Principles of Managed Health Care
• Occupational Health Risk Management
• Compensation for Occupational Injuries and Diseases Act
• Occupational Diseases in Mines and Works Act (preferable)
• Knowledge of managed care
• Mine Health and Safety Act (preferable)
• Occupational Health & Safety Act
• Knowledge of medical claims management policies, procedures, systems, and processes
• Leading and supervising
• Managing performance
• Judgment and decision-making
• Complex problem solving
• Persuading and Influencing
• Process engineering and systems competence
• Commercial orientation