Job Description

EXECUTIVE: MEMBER PROTECTION (5 YEARS FIXED-TERM CONTRACT)

To lead the development and implementation of the Member Protection objectives and functions of the client to ensure that members and beneficiaries of medical schemes are protected, serviced, and enabled. You will work within the client and report to the Chief Executive & Registrar.

Duties

• To lead and coordinate the development of the strategic plan, annual performance plan, and operational plans of the different Member Protection sub-divisions to ensure statutory reporting within set deadlines;
• To ensure alignment of strategy and budget allocations on an ongoing basis;
• To manage, monitor, and take accountability for performance of Complaints Adjudication, Customer Care, Clinical Consulting Services,

and Education & Training;

• To act as a professional advisor to the Council on all relevant matters on an ongoing basis;
• To develop, review and recommend changes to policies and implementation procedures for the approval to the relevant stakeholders as appropriate on an ongoing basis;
• To manage sub-ordinates on an ongoing basis within key deadlines according to their KPA's and KPI's;
• To liaise with external stakeholders and to develop strategic relationships to inform client strategy on an ongoing basis within key deadlines;
• To build and maintain long term relationships with expert support panels to ensure improved quality of service to meet company objectives on an ongoing basis;
• To ensure the active engagement with stakeholders on issues affecting the medical schemes environment and our regulatory function

through industry advisory committees on an ongoing basis;

• To ensure compliance with internal financial controls and the PFMA in the area under your control on an ongoing basis;
• To tie strategic objectives of the client to annual and medium-term budget proposals;
• Oversee and account for the management of audit activities effectively across Member Protection division;
• Oversee and account for the effective and efficient budget management activities within the division;
• Oversee and account for the management of effective and efficient risk management activities;
• To ensure daily optimum utilisation and improvement of the Human, Information and Organisational capital in your functional area to

improve the Organisation's utilisation of its Human, Information and Organisational resources; and

• To perform any additional responsibilities or tasks according to specifications as and when required.

Skills and Knowledge Base

• Master's degree qualification in Public Health or Legal or Business Management;
• A minimum of 15 years' overall experience, of which 5 years must be in a Senior Management role; 5 years in Complaints Management and 5 years in Private or Public health services;
• Sound knowledge of strategy and policy formulation;
• Knowledge of SAQA frameworks and Consumer Act/ Rights;
• SA's healthcare financing and delivery system, product knowledge and pricing;
• Knowledge of Medical Schemes Act and Healthcare environment;
• Knowledge of ethics and corporate governance;
• Knowledge of business risks and mitigation strategies;
• Knowledge of all related legislation impacting and influencing the functioning of the organisation (MSA, PFMA, BBBEEA, LRA, EEA etc.);
• People management, financial and project management skills;
• Excellent communication skills, complaints resolution skills;
• Attention to detail, analytical skills, and ability to handle pressure;
• Ability to motivate and influence others; and
• Computer literacy.

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