Chief Claims Officer (5 year fixed term contract)

SUMMARY:
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POSITION INFO:

• Responsible to ensure that all claims operations adhere to days claims processing requirements in line with the organization mandate.

Minimum Requirements

• Bachelor’s Degree in a Business Management or Administration related qualification.
• Post graduate Business Management or Administration related qualification.
• At least 12-15 years’ relevant experience of which 7 (seven) years must have been at a general/senior management level.
• Advanced knowledge in claims management systems, insurance/reinsurance principles and Motor Vehicle Accident legislation will be advantageous.
• Experience in leading and managing organisational transformation will be an added advantage

Competencies:

• Advanced knowledge of claims management process/ processes and systems.
• Understanding of claims medical management.
• Understanding of the claims mediation and litigation model.
• Complex problem identification, solving and decision making.
• Network and alliances
• Talent management.
• Knowledge of Motor Vehicle Accident legislation.
• PFMA knowledge.
• Knowledge of budgeting, sales, business development, and strategic planning.
• Strategic capability and leadership.
• Results orientation.
• Business and financial acumen.
• Brand and stakeholder orientation.
• Change management.
• Treasury regulations.
• Customer value proposition.
• Good financial management skills.
• Strong Analytical capabilities.

Key Performance Areas:

• Lead the development of functional reporting systems, for management, project or performance reporting.
• Provide oversight to the development of reports/ policies/ procedures and guide the process through the alignment of these documents to the overall organization’s Strategy.
• Oversee medical supply agreements, implement cost analysis strategies and negotiate with suppliers accordingly.
• Maintain relationships with the different claims counterparts to flag problems and risks, and proactively shape any regulatory guidance.
• Oversee the management of daily operations and functions for all claims processes within the Organization.
• Ensure that the claims received are assessed in accordance and aligned to merits thereof.
• Oversee the management of the full lifecycle of a claim process, including claims origination, receipt, validity and verification checks, merit
• assessments, quantum assessment, litigation, settling, payment, finalising and archiving of a claim, as well as the post-crash settlement care.
• Develop KPIs for new products, including measurement frameworks and data feedback strategies.
• Ensure quality control of all claims process outputs as it pertains to customer satisfaction and delivery of services.
• Identify customer trends and establish a matrix to measure proactive steps to maintain positive experiences.
• Oversee the development and maintenance of good working relations with stakeholders including staff, claimants, attorneys, regulators, government, departments etc.
• Prioritise communication with all levels of stakeholder contact.
• Effective management of claims financials.
• Develop business strategy and plan that ensure alignment with short-term and long-term objectives developed in tandem with the CEO.
• Drive the development, implementation and annual review of an overall strategic plan for the claims department.
• Determine and set specific key performance indicators and measures against outcomes detailed in the department business and claims strategic plans.
• Work with appropriate structures to ensure effective execution of policy and practices.
• Provide expert advice and guidance to the Policy department on legislative compliance, emerging issues, risk and the implementation of changes required on policy matters.
• Ensure that recruitment of operational workforce is in line with employment equity targets.
• Ensuring the motivation, cohesiveness, and alignment of the organization’s team members
• Lead and manage staff in the department to ensure that they achieve their objectives in line with the strategic objectives of the organization.
• Implement human capital processes and procedures to control/regulate workplace conflict and/or institute corrective measures and consultation processes to address deviations from standards.
• Report quarterly on progress with implementation of operational plans.
• Ensure regular and periodic reports are prepared and submitted as and when required to provide progress updates and/or inform management decisions.

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