Recruitment Vacancies at Rand Mutual - RMA

WHAT WILL YOU DO?

Growing the Top 50 business lives, handling and resolving service-related queries:

• Manage the team to provide a value proposition to the employers to enable the transfer and move to RMA.
• Assist and support the team in understanding the RMA products and promoting RMA products and generate leads for RMA Life Sales and Distribution.
• Provide first line product, process and technical support to customers.
• Identify up-selling and cross-selling opportunities through ongoing engagements with customers   by explaining product benefits to potential customers
• Follow up on leads and referrals as received from customer engagement
• Ensure adherence to TCF principles and report any transgressions
• Participate in ad hoc assignments as per role requirements

Customer experience management, liaising and maintaining good relationships with all the employers.:

• Design and implement innovative customer experience strategies, service business plans and improvement initiatives.
• Implement the customer service guidelines that include various protocols for efficiently providing customer services.
• Maintain a proper record of the customers including communication audit trails, billings, contact information, and other relevant details and updating the information of the customers regularly.
• Map key customer journeys.
• Provide complete information about our products to the customer.
• Develop and implement product and services reports by collecting and analysing the information provided by the customers.

Cost Management:

• Manage the implementation of cost saving initiatives.
• Assistance with budget control

Customer service and stakeholder relationship management:

• Follow up on customer by engaging with the relevant stakeholders to identify whether all issues have been resolved.
• Set up continuous sessions with the client to build relationships but more importantly to ensure that RMA is providing the right service.
• Assist stakeholders and service consultants with implementing the correct processes for query management.
• Responsible for brand management in general and internal relationship building management.
• Complete thorough research on trends and conduct root cause analyses to ensure that service failures are permanently corrected.
• Solve all product or service-related issues of the customers.
• Implement corrective actions across the network to retain and deliver excellent service to our members.
• Daily query management resolution.
• Complaints handling and resolution.
• Query management and SLA enforcement.
• Enforce adherence to deadlines for reports and feedback.
• Identify training requirements and develop a training plan for execution by the Stakeholder Training Officers.
• Ensure that training programs are organised for the benefit of all the stakeholders.
• Providing first line product, process and technical support to customers

Team Management:

• Provide general administration support and supervision of the Services team.
• Manage the customer service and distribution function and ensure that high customer experience levels are maintained.
• Handle and manage departmental enquiries and ensure compliance applications.
• Assume full management responsibility for the Customer Services and Distribution team.
• Ensure that ongoing coaching and development is provided to the team through infield observation.
• Continuously manage team performance and ensure that productivity is monitored on an ongoing basis.
• Set clearly defined objectives for each team member, lead and assist them in achieving these objectives; employ, retain, develop, integrate, motivate, remunerate and assign people to appropriate tasks, conduct performance management and ensure teamwork.
• Carry out the performance management (KPI) process to rate each employee’s performance and providing feedback to employees of their strengths and development areas on a monthly basis.
• Draft and submit professional management reports.

Risk and compliance management:

• Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled.
• Ensure that a compliance culture is embedded across the team.

WHAT YOU'LL BRING TO THE TABLE?

• NQF Level 7: Bachelor’s Degree in Business Administration or equivalent
• Advance courses/diploma in sales
• Honours or MBA (Advantageous)
• RE5
• RE1 (Advantageous)
• 8 – 10 years successful experience in a sales and service support environment within an insurance/ financial services environment.
• 5+ years of people leadership experience in building, managing and/or developing high-performing teams
• Excellent sales and service skills and business acumen with the capability to communicate with enthusiasm and drive.
• Broad knowledge of the products
• Must have strong know-how and ability to handle the customers pleasantly and resolve all their issues on time.
• Knowledge and understanding of the insurance business environment and associated legislation and regulatory compliance issues
• Valid driver’s license and must be willing to travel
• Experience in leveraging new technology (e.g., AI/ML, Chat, Bots, Voice and other emerging new technologies) to drive better stakeholder experiences and driving efficiency across channels.
• Experience in journey mapping, experience design, and business and IT agile principles and delivery of new capabilities.
• Demonstrated ability to effectively leverage internal and external data and research to understand trends shaping stakeholder expectations and leveraging the insights to enhance employee and member experiences.
• Experience collaborating with key resources and stakeholders, influencing decisions, and managing work to achieve strategic goals.
• Strong ability to deliver results and meet service delivery expectations

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WHAT WILL YOU DO?

Clinical Rehabilitation Pillar Tasks

Acute hospital case management:

• Receive referral acute reports from HUM, be able to interpret clinical information
• Liaison between acute treating team and employer
• Coordinate medical documents between MSP and employer
• Assist with discharge planning sub-acute unit / home discharge.

In sub- acute hospital:

• For each case, involvement in the: initial planning meeting (IPM), family meeting and discharge meetings sub-acute service provider
• Evaluate rehabilitation treatment, assistive device requests and authorize for medical invoice payments.
• Interpret rehabilitation plans and report appropriately
• Plan and coordinate discharge plan with RMA/ Employer and MDT
• Coordinate transitioning to Vocational Rehabilitation/ re-skilling programs
• Coordinate social reintegration: caregiver training/ home adaptation/ equipment authorization.
• Vocational Rehabilitation Pillar Tasks

 Return-to-Work Program:

• Coordinate pre-discharge family meeting with employee, employer, caregiver, and healthcare providers
• Approve/ authorise out-patient therapy for RTW support
• Coordinate Functional Capacity Evaluation (FCE) for work readiness assessment, workplace evaluation and adaptations
• Monitor post- RTW and reporting.

Job-Reskilling or Job Incubation Program:

• Perform 'Interest Interview' with employee to identify preferred/ suitable skills/jobs
• Engagement with re-skilling providers, oversee reskilling/job program success
• Authorise therapy for re-skilling support.

Bursary Program:

• Coordinate and aid in RMA bursary application, institution application
• Track candidate through college and report.

Social Re-integration Pillar Tasks

• Coordinate psychosocial support with relevant MSPs for intervention
• Coordinate all activities related to “independent living”: home adaptation, return to adaptive sport/ recreational tasks. Assess adaptive equipment and authorize. Link employee to relevant recreational organizations. Coordinate return to driving: engage relevant service providers/ agencies.

Home adaptations/ Care Facility admission

• Coordinate Social Worker/OT/PT for home evaluation and report- in SA and SADC
• Coordinate home adaptation process: finalization of claim (internal RMA liaison), coordinate funding of construction for recommended adaptations, liaison with employer. Track and report home adaptation success
• Assess suitability for long-term placement, where worker is severely impaired/ no caregiver. Coordinate placement options.

Reporting Tasks

Internal

• Daily record keeping on the tracking platform
• Tracking and document all interventions under the 3 pillars
• Provide monthly progress reports to rehab manager
• Monthly reports, statistics/ VR process
• Interdependent team: PMP, CCA, HUM, Welkom Rehab.

External

• Employer: rehab report with individual case management plan, interpretation, and relay RTW possibility
• MSP: authorization/ repudiation of rehab treatment/ equipment.

Service Provider: 

• Re-skilling SP, NGOs.

General rehabilitation case management outputs

• To re-assess the rehabilitation prognosis to sustainable return to work by looking at the medical prognosis, occupation as well as the claimants’ / pensioner’s response to treatment of possible cases referred to the case manager
• To motivate where applicable for claimant’s return to work
• To ensure that a quotation is obtained for claimants’ / pensioners’ specific rehabilitation programme and approval is requested via management
• To ensure that upon approval the case is referred to the relevant rehabilitation specialist (which usually includes an occupational therapist or other health professionals such as physiotherapist or psychologist, and specialists)
• To ensure that the case management programme / plan is discussed with the claimant / pensioner, employer, and family
• To monitor the rehabilitation progress closely through regular follows ups with the relevant independent therapist and the claimant / pensioner
• To monitor complex claims that may become long-term claims if no rehabilitation intervention is received
• To ensure early intervention and proactive case management of these cases by reviewing these claims and keeping in touch with claimants / pensioners and health professionals involved with treatment
• Assist with the review of independent occupational therapist reports with specific reference to the matching of functional impairment with the job requirements of nominated occupation and see if this ties up with their final recommendation or conclusion
• To assist with the analysis of a job based on information provided in a job profile form and comment on job classification or if an independent job analysis is required at an early stage

WHAT YOU'LL BRING TO THE TABLE?

• Physiotherapy, Occupational Therapy, Social Work, and Nursing
• Post Graduate diploma in vocational rehabilitation (Advantageous)
• HPCSA / SANC / Health care professional body registration
• 2-3 years’ experience in Clinical and Vocational assessments
• 3 years’ experience in Rehabilitation/ disability case management/ Return to work program
• 2-3 years Claims management (Advantageous)
• Microsoft package - Clinical management software
• Deciding and initiating action
• Communication/ Client liaison
• Willing to travel
• Working with People
• Analysing
• Planning & Organising

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WHAT WILL YOU DO?

• General administration support to Key account Executive.
• Standby assistance to Key account executive.
• Telephonic and e-mail query management.
• And effective feedback to clients.
• NON-COID New business management and professional feedback.
• Weekly and monthly reports management.
• Provide data and guides to help the sales team.
• Develop and monitor performance indicators.
• Manage sales tracking tools and report on important information.
• Keep record of sales trends.
• Liaise with Key account executive to develop specific sales strategies and ensuring happy clients.
• Stay up to date with new product and feature launches and ensure sales team is on board.
• Inter department enquiry management.
• Excellent customer service and effective communication.

WHAT YOU'LL BRING TO THE TABLE?

• NQF5/diploma in business management
• 3 years sales administrative support experience
• Advanced Computer literate - MS Office
• Ability to organize
• Ability to work under pressure
• Attention to detail and accuracy
• Verbal and written communication skills
• Professional personal presentation
• Customer service orientation
• Information management
• Organizing and planning
• Coordinating meetings
• Highly Numeracy level

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WHAT WILL YOU DO?

Key Responsibilities:

Product Design and Development

• Support and participate in the execution of the Life product strategy in an agile manner
• 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 RMA Life) 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, Legal 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 modelling 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
• Assume overall responsibility for each product project

Data Analysis and Reporting        

• Oversee the development of actuarial or statistical models to aid decision-making and for short- and long-term financial projections
• Analyse data to identify trends and key insights
• Develop and report on key performance and experience monitoring metrics
• Identify key trends and engage with business to understand the impact of these trends. Identify possible courses of action to take advantage of the trends identified
• Produce regular and ad-hoc reports and presentations as required
• Compile reports and presentations for the Exco, Board and Actuarial Committee

Legal and Compliance      

• Understand and ensure adherence to regulatory requirements and internal governance and control policies and procedures
• Prepare or review product specifications and actuarial reports

Oversee the provision of actuarial business support to RMA Life         

• Support the RMA Life business as a member of the divisional exco team
• Oversee the application of ORSA methodology and SAM processes and procedures
• Timeously respond to actuarial queries from the regulators (FSB/SARB/SARS)
• Plan and Budget actuarial matters and maintain a timetable of submission (financial projections)
• Inform management of actuarial specific regulatory issues (solvency and capital requirements) for the Group
• Ensure that a summary of returns and any actuarial issues are maintained to report to management (EXCO/BOARD/AUDIT etc)
• Prepare and present actuarial matters to the Board and act as an advisor to the Board and its sub-committees
• Monitor experience (reserving and pricing)
• Prepare actuarial specific areas in all the Group regulatory returns
• Monthly, Quarterly, Annual
• ORSA and SAM reporting

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
• Monthly reporting of the Key Performance indications for the actuarial reporting function
• Monthly report to FM on status of accounts and returns for EXCO submission
• Effective reporting and assessment of problem areas

Regulatory compliance      

• Ensure that all work is performed in terms of required standard and regulation
• Ensure that RMA’s position is translated into standards by assessing gaps in methodology, assumptions and overall products and align standards to RMA)
• Ensure that all company policies and procedures are adhered to
• Ensure timely submission of various periodical reports, highlights of the previous month’s reports

WHAT YOU'LL BRING TO THE TABLE?

Minimum Qualification       

• NQF Level 7: Bachelor’s degree – Actuarial Science
• Qualified Actuary
• Member of Actuarial Society /Institute of Actuaries

Minimum Experience         

• Minimum 8 years’ experience in an insurance regulatory environment
• Minimum 5 years’ experience within actuarial environment, with specific experience related to life insurance pricing and product.
• Proven experience in pricing and product management and strategy development.
• Strong knowledge of actuarial principles, methodologies, and relevant software tools (such as Excel, SAS, R, or Python).

Knowledge and Skills required     

• Advanced Excel
• Insurance knowledge is essential
• Reporting 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

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WHAT WILL YOU DO?

• Monitoring of Hospital Admissions weekly and liaison with Case Managers.
• Give feedback to Case Managers and other Colleagues of Pensioners admitted in Hospitals and include for hospital utilisation management.
• Authorization of Pensioners Hospital admissions, Chronic Medications and Sundries, prosthetic repairs and replacement
• Adjudicate requests for subsequent care and refer to RMA doctor as necessary.
• Assess and adjudicate medical service provider reports and advise on invoices submitted and captured when requested.
• Visit medical service providers and hospitals to address Pensioners related issues
• Organize and attend scheduled clinics.
• Organize transport for SCI acute admissions, uro reviews and taxi fares for prosthetic pensioners.
• Visit existing high risk/cost and new DRG 1 pensioners as per PMP schedule.
• Organizing uro reviews and capture the uro report.
• Organize prosthetic review clinic and load report on CC2.
• Assist to obtain death certificate and Notification of Death (if available) for deceased pensioners and autopsy reports if available.
• Assist with medical walk-in office clients.
• Capture Medical Reports via scanning in respect of pensioners, chronic medication, and subsequent care and specific medical reports requested.
• Assist with education of pensioners on entitlements.
• Updating DOCR with hospital pensioner admissions and discharges for DRG 1 to 3.
• Weekly/Monthly report of Pensioner URO reviews, home visits and prosthetic reviews and other interventions.
• Manage visa and passport expiry documents of SCI pensioners in Hospital.
• Managing and control of medical expenses as per yearly plan
• Follow up, from RMA system generated reports, high cost claims based on type of injury and estimated costs.

WHAT YOU'LL BRING TO THE TABLE?

• Nursing diploma /degree
• 3  years nursing experience as professional nurse
• Valid Driver’s License
• Own Transport
• Mandatory Travelling for home visits and mobile clinics
• Registration with Nursing Council or relevant Health Professional Council
• Building Customer Loyalty
• Contributing to Team Success
• Managing Work (includes Time Management)
• Stress Tolerance
• Decision Making
• Confidentiality
• Credibility
• Friendly
• Initiative
• Integrity