Job title : Manager: Masterfiles – Cape Town
Job Location : Western Cape, Cape Town
Deadline : July 20, 2024
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Requirements
- Matric
- Minimum of 3 – 5 years’ experience in the claims operations environment is essential
- In depth understanding of reference price lists and industry standard pricing structure is essential
- Business or management degree or studying towards will be advantageous
- A clinical qualification or extensive clinical knowledge will be advantageous
- High level of proficiency in Healthcare and Medical Scheme administration landscape
Duties & Responsibilities
Operational Management
- Managing the day-to-day operational functions by ensuring Momentum Health Solutions meets and exceeds SLA’s.
- Provide insights into what is driving transactional trends and provide innovative solutions to improving unnecessary volumes into Momentum Health Solutions environment.
- Actively pursue improvement in quality of back-office function processing.
- Oversee enquiry investigations and ensure that responses are comprehensive and well-constructed.
- Participate in regular operational and other forums as required by clients (All Momentum Health Solutions clients).
- Creating a positive working environment and optimise human capital outputs and quality.
- Management of Leave, overtime and productivity for team.
- Performance Management of team.
- Report on monthly / quarterly performance for the area under review as required by Scheme / Internal Stakeholders.
- Manage departmental budgets and employer asset base (hardware, software etc.)
- Ensure functional compliance with the Medical Scheme’s Act.
Audit Function
- Ensure that functional area perfects audit findings and where these occur facilitate remediation within timelines agreed with internal/external auditors.
Stakeholder Management
- Drive collaboration with internal stakeholders to ensure optimal value chain service delivery.
- Develop sound relationships with customer in order to foster trust and credibility.
- Attend industry platforms to ensure MH visibility.
- Ensure compliance with internal and external requirements.
Competencies
- Business Acumen
- Client / Stakeholder Commitment
- Drive for Results
- Leads Change and Innovation
- Motivating and Inspiring Team
- Strategic Thinking
- Collaboration
- Impact and Influence
- Self-Awareness and Insight
- Diversity and Inclusiveness
- Growing Talent
How to Apply for this Offer
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