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  • Posted: Jan 19, 2021
    Deadline: Not specified
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    • RMA in a nutshell Identifying a need to help care for miners who were injured while on duty, Rand Mutual (RMA) was founded in 1894 by three mining companies on the Witwatersrand as a non-profit mutual assurance company. Today RMA has grown to offer workmens'​ compensation benefits to the mining, iron, metal, steel and relate...
    Read more about this company

     

    Senior Actuarial Specialist - Pricing and Product Development

    An exciting opportunity exists within the Rand Mutual Assurance Actuarial team offering exposure to an interesting combination of technical and business issues.  This is a great time to join RMA as we look to grow the Life business and develop our actuarial team.

    Purpose

    • Reporting into the RML: Head of Actuarial, the incumbent will be responsible for the design and pricing of life products, as well as strategic actuarial support to the business. The incumbent will be responsible for leading product design, actuarial modelling, pricing, project management, and the overall provision of actuarial support and regulatory filings to the RML business.

    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 experience
    • Minimum 5 years’ experience in the regulatory/life insurance environment
    • Team leadership experience

    Key Areas of responsibility

    Actuarial business support:

    • Support with providing insights to the business
    • Assist with various exco, board and committee reports and packs
    • Support and participate in the execution of the RML strategy in an agile manner

    Product development:

    • Understand the business needs and related gaps to inform the design of product solutions
    • Understand the overall competitive landscape and commercial and economic environment through market research in order to help inform product design
    • Partner with various business stakeholders (including Sales and Distribution and the CEO of RML) to design innovative products that consider the end to end customer journey and policy lifecycle
    • Collaborate with support teams and risk areas in the product design process. This includes Customer Experience, Sales and Distribution, Claims, Lega and Compliance, Risk and IT
    • Present product features and actuarial results to project teams, management, and other stakeholders such as marketing and distribution
    • Apply pricing practices and develop modeling to set appropriate rates, understand profitability, and analyze sensitivities
    • Perform feasibility analyses and pricing projects for products, including deriving assumptions, constructing pricing models, performing in-depth risk and pricing analysis, producing product approval presentation, and support product filing and implementation
    • Analyse product profitability and recommend product design changes where necessary
    • Continually review, identify and promote best practices and opportunities for improvement to the products
    • Conduct experience investigations

    Leadership:

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

    Knowledge, Skills and Competencies required

    • Pricing and modelling experience
    • Knowledge of business policies, processes and procedures, legal compliance
    • Reporting experience
    • Knowledge of the Insurance Acts (long and short term) including SAM, IFRS17
    • Strong analytical skills with the ability to collect, organize, analyse, and disseminate information simply and effectively
    • Strong ability to work with, analyse and communicate findings from data (top-down verbal and written communication)
    • An ability to communicate technical complexity to a non-technical audience
    • Advanced Excel
    • Attention to detail
    • Analytical thinking

    go to method of application »

    Senior Actuarial Specialist - Valuations

    An exciting opportunity exists within the Rand Mutual Assurance Actuarial team offering exposure to an interesting combination of technical and business issues.  This is a great time to join RMA as we look to grow the Life business and develop our actuarial team.

    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 »

    Head of Medical

    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

    Method of Application

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