Career Opportunities at Britam

Job Purpose

Reporting to the Team Leader Corporate Care Management, The role holder will be responsible for control and managing of the policy cycle through pre-authorization and case management, to ensure quality and cost effective care.

Key responsibilities

• Set the appropriate parameters for each admission (claim reserve, initial authorized cost and duration)
• Interact with clients and service providers to ensure that the care is given within policy guidelines
• Review medical reports and claims for compliance with set guidelines
• Liaise with underwriters on scope of cover for the various schemes
• Ensure that medical scheme members are attended to round the clock with support from 24 hour call centre.
• Poly-Pharmacy – discourage poly-pharmacy by diligent challenging of prescriptions and suggesting better alternatives.
• Generic substitution – Encourage use of generics where indicated as a method of reducing the organizations pharmaceutical expenditure.
• Delegated Authority:  As per the approved Delegated Authority Matrix
• Prepare periodic reports for management on medical claims
• Ensure claims are processed within the stipulated time 
• Perform any other duties as may be assigned from time to time

Key Performance Measures

• As described in your Personal Score Card

Knowledge, experience and qualifications required

• Diploma/Degree in Nursing or Diploma in clinical medicine or Diploma in Pharmacy.
• Moderate understanding of insurance concepts
• Professional qualification in FLMI, ACII and IIK.
• 5-8 years’ experience in case management two of which should be in a supervisory position

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Job Purpose

Control and managing of the policy cycle through pre-authorization and case management, to ensure quality and cost effective care.

Key responsibilities

• Process all reimbursements as per SLA
• Process all claims from service providers as per SLA
• Process all reconciliation service provider invoices are reviewed and shared as per SLA 
• Accurate and timely processing of client requests
• Manage escalation reports of recurrent issues vis-à-vis agreed Service Level Agreements.
• Escalate quality issues to Operations manager for management.
• Implement the customer experience strategy in the respective business divisions
• Investigate and respond to all internal and external customer enquiries promptly.
• Escalate complex queries to the appropriate functional area
• Maintain regular internal (to staff) and external (to customers) communication on Customer Service matters.
• Investigate and respond to all customer enquiries promptly.
• Carry out customer and product related document processing
• Respond to customer queries in a professional manner
• Make customers’ experiences better by ensuring customer satisfaction
• Ensure high standards of Customer Service are maintained in all at level
• Set the appropriate parameters for each admission (claim reserve, initial authorized cost and duration)
• Interact with clients and service providers to ensure that the care is given within policy guidelines
• Review medical reports and claims for compliance with set guidelines
• Liaise with underwriters on scope of cover for the various schemes
• Ensure that medical scheme members are attended to round the clock with support from a 24 hour call centre.
• Poly-Pharmacy – discourage poly-pharmacy by diligent challenging of prescriptions and suggesting better alternatives.
• Generic substitution – Encourage use of generics where indicated as a method of reducing the organizations pharmaceutical expenditure.
• Prepare periodic reports for management on medical claims
• Ensure claims are processed within the stipulated time

Knowledge, experience and qualifications required

• Diploma/Degree in Nursing or Diploma in clinical medicine or Diploma in Pharmacy.
• Moderate understanding of insurance concepts
• Professional qualification in FLMI, ACII and IIK added advantage
• 2-3 years’ experience in medical claims or case management position

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Job Purpose and Key responsibilities

Growth of IFA business to meet set annual premium targets.     

Key responsibilities

• Secure new corporate business through intermediaries
• Retain existing corporate business as per set objectives
• Maintain excellent customer service to intermediaries and clients 
• Service existing business and resolve customer complaints 
• Follow up on renewals for corporate general insurance business
• Forward proposal forms to underwriting department
• Follow up premium collections for corporate clients
• Prepare weekly  and daily reports as required 
• Undertake initial underwriting in accordance with set guidelines to ensure sound acceptance of risk 
• Respond to customer and client enquiries
• Follow up on commissions and claims issues emanating from intermediaries
• Recruitment of intermediaries as per set objectives
• Conversion of FA’s and IFA’S  in the market to ensure all are placing corporate general insurance business
• Continuous execution of initiatives and strategies per market to ensure meeting of set objectives and reviewing them where need be. 
• Training of intermediaries on general insurance products and submitting training schedules to supervisors. 
• Use authorised incentive scheme to bring in new business through training intermediaries on the same and marketing it. 
•  Creating strategic partnerships with intermediaries for maximum business support. 
• Sharing of market intelligence with supervisor
• Work closely with underwriter and branch manager and other lines of business to achieve set objectives
• Perform any other duties as may be assigned from time to time
• Delegated Authority: As per the approved delegated authority matrix 

Key Performance Measures

• As described in your Personal Score Card

Knowledge, experience and qualifications required

• Bachelors’ degree in a business related field
• Professional qualification in Insurance (ACII, IIK)
• 2-4  year’s relevant experience in the insurance industry