Job Description

Job Advert Summary

The Fund Manager will be responsible for the strategic and operational oversight of the Schemes administered by PPS Healthcare Administrators. This includes ensuring optimal Scheme performance, sustainability and compliance with regulatory requirements. The role serves as a central point of coordination between the Scheme, clinical risk management, client relationship management and other stakeholders.

Minimum Requirements

Education

Bachelor's Degree

Experience

Minimum 5-7 years' experience in medical scheme or scheme administration with Fund management experience Strong understanding of CMS regulations, managed care principles, and scheme operations At least 5 years managerial experience Excellent verbal and written communication skills Ability to meet tight deadlines Report writing skills Excellent communication and presentation skills Ability to navigate complex data and turn insights into action

Duties and Responsibilities

Strategic Scheme Oversight Acting as the primary contact point for the Scheme with the administrator. Develop and present Scheme performance dashboards to internal and external stakeholders. Provide input on benefit design, pricing, in collaboration with actuarial partners. Act as an advisor to the Scheme and internal committees on matters related to Scheme health and performance. Collaborate with the operational and clinical teams to align operational performance with Scheme objectives. Oversee the collation and production of the Scheme reports in accordance with the Scheme's SLA requirements. Ensure that the Scheme reports are accurate, produced on time and in accordance with the layout as required by the Scheme. Drive continuous improvements in Scheme reporting and data analytics. Identify opportunities to integrate digital tools to enhance Scheme oversight. Organise, manage and implement all aspects of the communications function required of PPS Healthcare Administrators. Advise the Scheme of any difficulties experienced with any service provider that will have an impact on the delivery of the service by PPS Healthcare Administrators. Responsible for the Scheme relationship. Ensuring all requirement of the schemes are addressed Interpretation, monitoring and analysis of claim trends Coordination of all member communication * Coordination of annual benefit review with PPS Healthcare Administrators.