Senior Manager: Complaints Management – Medical Scheme - Pretoria

Key Performance Areas (KPAs):

? Design and ensure Complaint Handling, reporting and product review processes are compliant with Scheme procedural requirements, Medical Scheme Act no 131 of 1998 and requisite regulations;
? Design and coordinate Scheme-wide complaint processing and reporting training programmes for the Complaint Unit, Internal Divisions and company Service Provider Network (SPN) as required;
? Design, distribute and educate the Scheme officers on product complaints and performance metrics (e.g. weekly, monthly, quarterly, and annually);
? Ensure effective collaboration with other divisions identifying, testing and implementing of process and system improvements;
? Participate in product design and support the Scheme’s corporate strategy to launch and sustain products as well as receive, investigate product complaints, process complaint documentation and report adverse events where applicable;
? Strong tactical decision-making and interact with multiple divisions to obtain information about complaints and handle unforeseen issues;
? Conduct research on industry leading practices for complaints matters pertaining to the medical scheme and healthcare industry including best practices;
? Undertake any other activities related to the above as may be assigned from time to time by the Executive which includes but is not limited to PO Complaints and Council for Medical Scheme (CMS) Complaints; and
? Reporting to various Committees of the Board of Trustees.

Qualification, skills and competencies requirements are:

? Degree and a relevant post graduate qualification;
? Must have at least 8 years functional experience with at least 5 years at a management level;
? Complaints management, customer service and/or legal experience, including knowledge of risk management requirements and controls;
? Excellent people management and leadership abilities;
? Superior communication, facilitation and consensus-building skills;
? Demonstrated relationship-building skills, with a superior ability to make things happen through the use of positive influence;
? High degree of personal initiative;
? Organizational awareness with an understanding of how to engage the organisation to get things done;
? Strong problem-solving skills; comfortable tackling complex problems and breaking
? these down into manageable pieces;
? Superior multi-tasking skills and the ability to work in a fast-paced, often deadline oriented and dynamic environment;
? Conceptual and practical thinking and implementation skills;
? Process design and analysis skills, research, analysis and judgment skills;
? Strong PowerPoint skills, intermediate Excel skills;
? Project management experience; and
? Sound understanding of medical scheme industry.