Head of Medical at SanlamAllianz General Insurance | Kigali :Deadline: 05-11-2024

SanlamAllianz General Insurance Plc is seeking to recruit a highly skilled, self-motivated, and experienced person to fill the position/post of Head of Medical.

The person holding this position will be reporting to the Chief Executive Officer. He/She will be responsible for managing all activities of the Medical Insurance scheme including contracting and inspection of Health Service Providers, providing medical benefits to rightful members, client retention, and brand promotion.

Key Duties and Responsibilities

1. Oversee the processes of contracting and inspection of Health Service Providers and follow up contracts’ execution
2. Coordinate activities related to facilitation of access to medical benefits by eligible members
3. Ensure quality and timely service to customers by managing requests/claims related to medical benefits according to the standards in place
4. Plan, organise and manage all activities of department, to ensure excellent, effective customer service delivery to members, health service providers and other stakeholders
5. Oversee verification of medical and pharmaceutical invoices and approve benefits payments to health service providers
6. Ensure accuracy and timely payment of services provided to members and put in place strong control mechanisms according to SanlamAllianz General Insurance GI Plc standards, contracts terms and regulations
7. Develop and propose policies and strategies aimed at enhancing contracting of health service providers, accessibility of quality service to members and payment of medical and pharmaceutical benefits
8. Oversee all activities related to prevention, detection and investigation of fraud and malpractice cases and devise mitigation strategies
9. Develop and implement strategic and operational plans and related budgets for the medical function
10. Ensure timely preparation, review and submission of periodic and annual progress reports on the implementation of approved strategic and operational plans
11. Participate in the preparation and coordination of actuarial valuation of the scheme and monitor the implementation of actuarial recommendations
12. Ensure the scheme’s cost containment through regular analysis of trends and patterns, monitoring of members’ behaviour towards service utilization
13. Lead implementation of specific key performance indicators and measures against outcomes detailed in the medical function’s strategic and operational plans as set out by the Executive
14. Develop and implement business strategy that results in increased coverage and enhanced contributions
15. Follow up the accident cases traceability, initiate subrogation process and ensure that related repayments are made
16. In collaboration with the Human Capital function, participate in the recruitment, management and evaluation of staff under his/her supervision
17. Perform any other duties related to the Medical Insurance function as may be assigned from time to time
    
    
    

Key Qualifications and Experience

The successful candidate must have at least:

• Master’s Degree in a Clinical Medicine Field, Pharmacy, Health Sciences, Health Economics, or any other relevant field preferably with 5 years’ experience, 2 of which should have been in a managerial role

OR

• Bachelor’ Degree in General Medicine, Pharmacy, Health Sciences, or any other relevant field preferably with 6 years’ experience, 2 of which should have been in a managerial role

Key Competencies

Technical Competencies:

1. The role holder must have solid knowledge of public health policies
2. The incumbent must have a strong background in clinical medicine
3. The role holder should have good working knowledge and understanding in basic actuarial methods and ability to analyse data and draw inferences
4. The role holder must have sound knowledge and understanding on labour legislation

Behavioral Competencies: 

1. Must demonstrate impeccable customer service focus, strategic thinking, and strong ethical background with an ability to resist and zero tolerance for corrupt, political and other undesirable influences
2. Must be able to establish and maintain constructive and effective relationships with key stakeholders and staff alike
3. Must be open to change and adapt established methods for new uses within the institution
   
   
   

The application should include the following:

1. Motivation letter
2. Updated CV, including three professional references. References should include the current direct supervisor or previous direct supervisors with their full names, phone number and email address.
3. Copies of degrees or certificates
4. Copy of national ID card/passport.

“Only applicants fulfilling the above requirements will be contacted.”

Interested candidates should send their cover letter and well detailed CV no later than November 5th 2024 via the apply button below.

Click here to visit the website source