Job Purpose

Head of Operations – Medical will oversee the company’s ongoing Medical Insurance operations and procedures as well as be as the budget. The Head of Operations Shall be responsible for ensuring set and agreed performance target be achieved. The head of operations is a key member of the senior management team reporting to the CEO-Medical Division.

Key Responsibilities

• Oversee the entire Operations of the relevant Division.
• Oversee the Company’s Operations in negotiating with Healthcare providers including.
• Lead the Company in negotiating with Healthcare providers including Ambulance Service Providers and Health Education and Promotion Providers, prices for services rendered and contract terms that are favorable to the Company.
• Lead the Company by identifying and building relationships with Healthcare Providers in East Africa, Asia and Southern Africa to ensure Strategis customers receive affordable and seamless services when referred for foreign treatment.
• Ensure accreditation of Healthcare Providers is professionally done as per the Company guidelines so that the interests of the Company in relation to Claims Management are protected.
• Lead the Company by identifying business opportunities in the market and negotiating and concluding deals and develop products and services that must result in the Company’s increased market share and profitable growth.
• Lead employees to encourage maximum performance and dedication and foster a corporate culture that promotes ethical practices, customer focus and establish policies that promote company culture and vision.
• Ensure retention of existing insured portfolio through thorough customer management and servicing.
• Maintain close relationship with all intermediaries which would aid in retaining clients as well as securing new clients.
• Evaluate Product designs and Service Providers’ performance by analyzing and interpreting data and metrics and thereafter guide the Underwriting and Claims teams in terms of product structure, pricing and opportunities for negotiations with Clients and Claims teams in Hospitals.
• Develop in collaboration with the Executive Management SOPs and Guidelines for all operational processes including medical claims adjudication management and innovate and implement Medical Insurance saving strategies including fraud detection IT-driven processes and management and other case management intervention into every operational matter of the company.
• Oversee and ensure the core insurance system functionality and stability in relation to operations and claims.
• Keep the CEO-Medical Division fully informed in a timely and candid manner of the conduct of the day-to-day operations of the Medical Insurance division towards the achievement of its established goals.
• Explore and implement further innovative IT solutions to improve efficiencies and cost management.
• Engage in medical claims management and innovate and implement Medical Insurance saving strategies including fraud detection and management and other case management interventions.

Knowledge and Experience

Qualifications:

• Bachelor’s degree in a health-related field; insurance-related qualifications will be an added advantage.

Work Experience:

• At least five (5) years of experience in a managerial role preferably in an insurance, healthcare sector or any other relevant sector.

Attributes

Key Attributes required for the Job:

• Outstanding organizational and leadership abilities.
• Demonstrable competency in strategic planning and business development.
• Excellent interpersonal and public speaking skills.
• Working knowledge of data and performance metrics/operation metrics.
• Aptitude in analytics, decision-making and problem-solving.
• Strong communication and interpersonal skills, with the ability to effectively interact with stakeholders at all levels of the organization.
• Ability to work independently, prioritize tasks, and meet deadlines.

Other attributes required for the Job:

• Demonstrates proven integrity and ethical conduct.
• Honest, transparent, trustworthy in all dealings.
• Passionate and committed to social development initiatives.
• Forward-thinking and visionary in approach.
• Emotionally intelligent and mature.
• Maintains a positive, adaptable, and optimistic outlook.
• Proactive, adaptable, and open-minded.
• Energetic, enthusiastic, and highly driven.
• Possesses strong judgment with tact and diplomacy.
• Exercises sound judgment with tact and leadership capabilities.
• Effectively communicates ideas and perspectives consistent with the Company’s vision, values, and brand.

• Oversee the entire Operations of the relevant Division.
• Oversee the Company’s Operations in negotiating with Healthcare providers including.
• Lead the Company in negotiating with Healthcare providers including Ambulance Service Providers and Health Education and Promotion Providers, prices for services rendered and contract terms that are favorable to the Company.
• Lead the Company by identifying and building relationships with Healthcare Providers in East Africa, Asia and Southern Africa to ensure Strategis customers receive affordable and seamless services when referred for foreign treatment.
• Ensure accreditation of Healthcare Providers is professionally done as per the Company guidelines so that the interests of the Company in relation to Claims Management are protected.
• Lead the Company by identifying business opportunities in the market and negotiating and concluding deals and develop products and services that must result in the Company’s increased market share and profitable growth.
• Lead employees to encourage maximum performance and dedication and foster a corporate culture that promotes ethical practices, customer focus and establish policies that promote company culture and vision.
• Ensure retention of existing insured portfolio through thorough customer management and servicing.
• Maintain close relationship with all intermediaries which would aid in retaining clients as well as securing new clients.
• Evaluate Product designs and Service Providers’ performance by analyzing and interpreting data and metrics and thereafter guide the Underwriting and Claims teams in terms of product structure, pricing and opportunities for negotiations with Clients and Claims teams in Hospitals.
• Develop in collaboration with the Executive Management SOPs and Guidelines for all operational processes including medical claims adjudication management and innovate and implement Medical Insurance saving strategies including fraud detection IT-driven processes and management and other case management intervention into every operational matter of the company.
• Oversee and ensure the core insurance system functionality and stability in relation to operations and claims.
• Keep the CEO-Medical Division fully informed in a timely and candid manner of the conduct of the day-to-day operations of the Medical Insurance division towards the achievement of its established goals.
• Explore and implement further innovative IT solutions to improve efficiencies and cost management.
• Engage in medical claims management and innovate and implement Medical Insurance saving strategies including fraud detection and management and other case management interventions.

• Outstanding organizational and leadership abilities.
• Demonstrable competency in strategic planning and business development.
• Excellent interpersonal and public speaking skills.
• Working knowledge of data and performance metrics/operation metrics.
• Aptitude in analytics, decision-making and problem-solving.
• Strong communication and interpersonal skills, with the ability to effectively interact with stakeholders at all levels of the organization.
• Ability to work independently, prioritize tasks, and meet deadlines.
• Proven integrity and ethical conduct.
• Honest, transparent, trustworthy in all dealings.
• Passionate and committed to social development initiatives.
• Forward-thinking and visionary in approach.
• Emotionally intelligent and mature.
• Maintains a positive, adaptable, and optimistic outlook.
• Proactive, adaptable, and open-minded.
• Energetic, enthusiastic, and highly driven.
• Possesses strong judgment with tact and diplomacy.
• Exercises sound judgment with tact and leadership capabilities.
• Effectively communicates ideas and perspectives consistent with the Company’s vision, values, and brand.

• Bachelor’s degree in a health-related field; insurance-related qualifications will be an added advantage.